Individual
SUMMER WINTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2321 SW 137TH ST, OKLAHOMA CITY, OK 73170-5142
(405) 200-5676
Mailing address
2321 SW 137TH ST, OKLAHOMA CITY, OK 73170-5142
(405) 200-5676
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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