Individual
MRS. CASIE WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9103 E 510 RD, CLAREMORE, OK 74019-0865
(918) 289-7139
Mailing address
9103 E 510 RD, CLAREMORE, OK 74019-0865
(918) 289-7139
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
216647
OK
Other
Enumeration date
04/03/2025
Last updated
04/03/2025
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