Individual
MRS. LORETTA J GIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41116 E COUNTY ROAD 1240, KEOTA, OK 74941-6517
(918) 697-2909
Mailing address
41116 E COUNTY ROAD 1240, KEOTA, OK 74941-6517
(918) 697-2909
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1908
OK
Other
Enumeration date
03/30/2021
Last updated
03/30/2021
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