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Individual

BRETT WAYNE PURNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAT, ATC

Contact information

Practice address
709 OKLAHOMA BLVD, ALVA, OK 73717-2749
(580) 327-8627
Mailing address
1800 OKLAHOMA BLVD APT 10, ALVA, OK 73717-1744
(316) 708-9085

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1260
OK

Other

Enumeration date
07/12/2022
Last updated
07/12/2022
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