Individual
MRS. ANGELA DENISE PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CM
Contact information
Practice address
1515 W CHICKASAW AVE, SALLISAW, OK 74955-7201
(918) 775-2657
(918) 775-0439
Mailing address
1515 W CHICKASAW AVE, SALLISAW, OK 74955-7201
(918) 775-2657
(918) 775-0439
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
20916
OK
Other
Enumeration date
08/26/2008
Last updated
08/26/2008
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