Individual
AUDREA JUNE NEBLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1026 N BYRD ST, TISHOMINGO, OK 73460-1504
(580) 371-0031
Mailing address
1026 N BYRD ST, TISHOMINGO, OK 73460-1504
(580) 371-0031
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
01/15/2013
Last updated
01/15/2013
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