Individual
RACHEAL BRUCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
619 N MAIN ST, MUSKOGEE, OK 74401-4431
(918) 682-8407
Mailing address
10007 S 105TH ST E, BRAGGS, OK 74423-5037
(918) 348-4693
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0066670
OK
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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