Individual
RILEY BANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
700 NE 13TH ST, OKLAHOMA CITY, OK 73104-5004
(470) 040-5271
Mailing address
2548 NW 184TH ST, EDMOND, OK 73012-0681
(785) 230-6863
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5344
OK
Other
Enumeration date
10/30/2024
Last updated
10/30/2024
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