Individual
MARY BETH CAROTHERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1215 NW 25TH ST, OKLAHOMA CITY, OK 73106-5629
(405) 525-2525
Mailing address
903 DELMAR CIR, MOORE, OK 73160-6505
(405) 923-0405
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L 0059534
OK
Other
Enumeration date
03/18/2011
Last updated
03/18/2011
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