Individual
DONNA POORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3009 COLQUIT RD, WICHITA FALLS, TX 76309-5009
(940) 249-4394
Mailing address
3009 COLQUIT RD, WICHITA FALLS, TX 76309-5009
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
174785
TX
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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