Individual
TISHA BURNSIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 N AIRPORT RD, WEATHERFORD, OK 73096-3351
(405) 424-7711
Mailing address
10465 N 2407 RD, WEATHERFORD, OK 73096-3109
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/17/2023
Last updated
02/17/2023
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