Individual
AMELIA BROOKE GAMBOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PRSS
Contact information
Practice address
300 N DALTON ST, VALLIANT, OK 74764-8029
(580) 203-3600
(833) 402-9799
Mailing address
1585 PEAVEY CROSSING RD, BROKEN BOW, OK 74728-5637
(580) 372-3784
(833) 402-9799
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/10/2020
Last updated
12/10/2020
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