Individual
ALECIA GOSSETT I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
308 W. SMISER, CALERA, OK 74730-0386
(580) 434-5603
Mailing address
PO BOX 386, CALERA, OK 74730-0386
(580) 434-5603
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
251K00000X
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578691184
—
OK
Enumeration date
10/04/2016
Last updated
10/04/2016
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