Individual
MISS AMELIA LEIGH POITEVINT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
202 E CHEROKEE AVE, SALLISAW, OK 74955-4600
(918) 223-3664
Mailing address
PO BOX 622, SALLISAW, OK 74955-0622
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
03/18/2011
Last updated
03/21/2012
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