Individual
DR. SUSAN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
215 N CLARENCE NASH BLVD, WATONGA, OK 73772-3645
(580) 623-2300
(580) 623-7533
Mailing address
215 N CLARENCE NASH BLVD, WATONGA, OK 73772-3645
(580) 623-2300
(580) 623-7533
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1010
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100760870A
—
OK
01
—
1010
LICENSE
OK
Enumeration date
10/10/2006
Last updated
10/28/2010
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