Individual
MARIA MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
300 WANDA ST, MARIETTA, OK 73448-1200
(580) 276-3347
Mailing address
300 WANDA ST, MARIETTA, OK 73448-1200
(580) 276-3347
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2598
OK
Other
Enumeration date
01/06/2016
Last updated
01/06/2016
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