Individual
MS. LISA DANETTE WEST
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
520 S TELEPHONE RD, MOORE, OK 73160-5423
(405) 793-9355
(405) 793-1621
Mailing address
3555 NW 58TH ST, SUITE 900, OKLAHOMA CITY, OK 73112-4707
(405) 917-0418
(405) 917-0419
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1163
OK
Other
Enumeration date
01/25/2006
Last updated
07/08/2007
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