Individual
TINA MARIE BOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R,N
Contact information
Practice address
201 E CHESTNUT AVE, PONCA CITY, OK 74601-4311
(580) 763-0931
Mailing address
2129 JOHN ST, PONCA CITY, OK 74601-1818
(580) 763-7536
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
100145
OK
Other
Enumeration date
09/27/2011
Last updated
09/27/2011
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