Individual
LOUANN WISEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1404 W MAIN ST, DUNCAN, OK 73533-4331
(580) 606-2419
Mailing address
1302 W ELM AVE, DUNCAN, OK 73533-4753
(580) 606-2419
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/18/2017
Last updated
03/30/2018
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