Individual
MRS. STEPHANI BROOKE BRISBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2950 S ELM PL, BROKEN ARROW, OK 74012-7877
(918) 451-5191
Mailing address
364355 E 5000 RD, CLEVELAND, OK 74020-6904
(931) 436-7146
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2857
OK
Other
Enumeration date
04/09/2018
Last updated
04/09/2018
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