Individual
LORIE GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1515 NE LAWRIE TATUM RD, LAWTON, OK 73507-3002
(580) 354-5391
Mailing address
PO BOX 307, FORT COBB, OK 73038-0307
(405) 668-2585
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0034191
OK
Other
Enumeration date
09/19/2015
Last updated
09/19/2015
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