Individual
MICHAEL E. CONNELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10756 E FAWN LN, TALALA, OK 74080-9444
(918) 261-1201
Mailing address
10756 E FAWN LN, TALALA, OK 74080-9444
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/19/2010
Last updated
05/19/2010
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