Individual
DONNA AULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
114 W DELAWARE AVE, NOWATA, OK 74048-2601
(918) 273-1841
(918) 273-1843
Mailing address
114 W CHEROKEE AVE, NOWATA, OK 74048-2603
(918) 273-1841
(918) 273-1843
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/14/2017
Last updated
04/14/2017
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