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Individual

MRS. KATRINA JO GOFORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
B.S

Contact information

Practice address
RR 1 BOX 131C, EUFAULA, OK 74432-9223
(918) 452-3133
(918) 452-3939
Mailing address
3206 S 117TH EAST AVE, TULSA, OK 74146-1931
(918) 408-4671
(918) 832-8775

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
05/25/2010
Last updated
05/25/2010
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