Individual
MISS RHONDA FAYE WHITTACRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1204 SW 22ND ST, MOORE, OK 73170-7484
(405) 208-0126
Mailing address
1204 SW 22ND ST, MOORE, OK 73170-7484
(405) 208-0126
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
OK
Other
Enumeration date
01/14/2013
Last updated
01/14/2013
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