Individual
MOLLY DIGIANTOMASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6721 NW 42ND ST, BETHANY, OK 73008-2698
(405) 499-4615
Mailing address
6721 NW 42ND ST, BETHANY, OK 73008-2698
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
212684
OK
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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