Individual
JORETA REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 NE LAWRIE TATUM RD, LAWTON, OK 73507-3002
(580) 354-5411
Mailing address
1515 NE LAWRIE TATUM RD, LAWTON, OK 73507-3002
(580) 354-5411
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0045083
OK
Other
Enumeration date
02/03/2017
Last updated
02/03/2017
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