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Individual

DR. LAURI SUE BLESCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
10512 N 110TH EAST AVE, STE 240, OWASSO, OK 74055-6636
(918) 376-8901
(918) 376-8929
Mailing address
10512 N 110TH EAST AVE, SUITE 240, OWASSO, OK 74055-6636
(918) 376-8901
(918) 376-8929

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
17769
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100122190C
OK
Enumeration date
05/12/2006
Last updated
05/01/2014
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