Individual
TINA MARIE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
407 W SOUTH AVE, PONCA CITY, OK 74601-6133
(580) 749-5056
(580) 215-5756
Mailing address
407 W SOUTH AVE, PONCA CITY, OK 74601-6133
(580) 749-5056
(580) 215-5756
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/26/2020
Last updated
05/19/2023
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