Individual
OCTOBER LYNNELL BURRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19225 STATE HIGHWAY 1E, ADA, OK 74820-5347
(580) 399-9305
Mailing address
4021 DEBI ST, ADA, OK 74820-4757
(580) 399-9305
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
OK
Other
Enumeration date
03/11/2026
Last updated
03/11/2026
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