Individual
MRS. BLAINE CATHERINE WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 E CHESTNUT AVE, PONCA CITY, OK 74601-4311
(580) 763-6017
Mailing address
201 E CHESTNUT AVE, PONCA CITY, OK 74601-4311
(580) 763-6017
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/10/2017
Last updated
10/10/2017
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