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Individual

JOY DIANE BUTLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
110 N 4TH ST, PONCA CITY, OK 74601-4527
(580) 749-5056
(580) 215-5765
Mailing address
110 N 4TH ST, PONCA CITY, OK 74601-4527
(580) 749-5056
(580) 215-5765

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0095792
OK

Other

Enumeration date
12/26/2019
Last updated
12/26/2019
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