Individual
TANAKA CANTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
411 S CENTRAL AVE, IDABEL, OK 74745-6059
(580) 286-7876
(580) 286-5721
Mailing address
PO BOX 1030, ANTLERS, OK 74523-1030
(580) 298-2830
(580) 298-6723
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0052993
OK
Other
Enumeration date
06/30/2016
Last updated
07/01/2016
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