Individual
ERICKA BURLESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
193461 E CO RD 304, FORT SUPPLY, OK 73841
(580) 766-2311
Mailing address
193461 E CO RD 304, FORT SUPPLY, OK 73841
(580) 766-2311
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/06/2022
Last updated
01/06/2022
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