Individual
LAVONDA D COFFEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
145 S 36TH WEST AVE, TULSA, OK 74127-8123
(918) 378-8089
Mailing address
145 E 36TH W AVE, TULSA, OK 74127
(918) 378-8089
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
02/01/2013
Last updated
02/27/2013
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