Individual
DEBORAH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15124 SOUTH 241ST EAST AVENUE, COWETA, OK 74429
(918) 486-4154
Mailing address
15124 SOUTH 241ST EAST AVENUE, COWETA, OK 74429
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/26/2019
Last updated
09/26/2019
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