Individual
CHASTITY LYNN HOLGERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12770 SE 149TH ST, OKLAHOMA CITY, OK 73165-6701
(405) 774-4845
Mailing address
12770 SE 149TH ST, OKLAHOMA CITY, OK 73165-6701
(405) 774-4845
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
02/13/2023
Last updated
02/16/2023
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