Individual
SHETINA BUNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11321 N FLORIDA AVE, OKLAHOMA CITY, OK 73120-7931
(405) 637-3131
Mailing address
11321 N FLORIDA AVE, OKLAHOMA CITY, OK 73120-7931
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
004714024
OK
Other
Enumeration date
08/09/2011
Last updated
08/09/2011
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