Individual
THERESA FOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6612 NW 38TH ST UNIT 396, BETHANY, OK 73008-3483
(918) 944-6788
Mailing address
6612 NW 38TH ST UNIT 396, BETHANY, OK 73008-3483
(918) 944-6788
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0045520
OK
Other
Enumeration date
10/22/2024
Last updated
10/22/2024
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