Individual
SHALEEN FAY COLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 N 4TH ST, PONCA CITY, OK 74601-4527
(580) 749-5056
Mailing address
419 W 11TH ST, NEWKIRK, OK 74647-5512
(620) 660-5854
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/07/2019
Last updated
09/04/2019
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