Individual
ANTOINETTE HARDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 E ILLINOIS AVE, VINITA, OK 74301-3202
(918) 256-9961
Mailing address
120 E ILLINOIS AVE, VINITA, OK 74301-3202
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
43216
OK
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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