Individual
IRMA ALICIA TREVINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4829 NW FLOYD AVE, LAWTON, OK 73505-1628
(580) 458-9343
Mailing address
4829 NW FLOYD AVE, LAWTON, OK 73505-1628
(580) 458-9343
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/26/2020
Last updated
06/26/2020
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