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Individual

ENOLA GAY CRAYTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.P.N.

Contact information

Practice address
707 S 28TH ST, CLINTON, OK 73601-4903
(580) 309-0943
Mailing address
707 S 28TH ST, CLINTON, OK 73601-4903
(580) 309-0943

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0020585
OK

Other

Enumeration date
01/27/2009
Last updated
01/27/2009
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