Individual
MRS. VICTORIA SUSAN PEEVYHOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4636 S HARVARD AVE, TULSA, OK 74135-2908
(918) 216-4917
Mailing address
31 E FAIRLANE CT, SAPULPA, OK 74066-7091
(918) 260-2996
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
51778
OK
Other
Enumeration date
08/01/2016
Last updated
08/01/2016
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