Individual
SANDRA LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
204 E GORE BLVD, LAWTON, OK 73501-3047
(580) 483-2289
Mailing address
204 E GORE BLVD, LAWTON, OK 73501-3047
(580) 483-2289
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/18/2014
Last updated
02/18/2014
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