Individual
MRS. MARISSA NICOLE MCREYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
602 SW 38TH ST, LAWTON, OK 73505-6912
(580) 248-5780
Mailing address
602 SW 38TH ST, LAWTON, OK 73505-6912
(580) 248-5780
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
01/15/2021
Last updated
01/15/2021
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