Individual
CARA LYNELL CUSICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1921 NW 177TH ST, EDMOND, OK 73012-6970
(405) 285-7443
Mailing address
1921 NW 177TH ST, EDMOND, OK 73012-6970
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
OK
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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