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Individual

FREDERICK CASTRO SANDOVAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.P.N.

Contact information

Practice address
619 N MAIN ST, MUSKOGEE, OK 74401-4431
(918) 687-1039
(918) 683-9484
Mailing address
619 N MAIN ST, MUSKOGEE, OK 74401-4431
(918) 687-1039
(918) 683-9484

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0063313
OK

Other

Enumeration date
10/15/2015
Last updated
10/15/2015
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