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Individual

CRYSTAL A MAHANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1322 KLABZUBA AVE, PRAGUE, OK 74864-4900
(405) 567-4922
Mailing address
2732 NW 155TH ST, EDMOND, OK 73013-8812
(409) 434-8257

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2955
OK

Other

Enumeration date
11/29/2018
Last updated
04/28/2025
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