Individual
TRACEY LORANN BIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
827 E HUBBARD RD, PONCA CITY, OK 74601-1073
(580) 762-3217
Mailing address
189 QUAIL RIDGE RD, PONCA CITY, OK 74604-6078
(580) 761-3595
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
45845
OK
Other
Enumeration date
11/13/2020
Last updated
11/13/2020
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