Individual
BRISA MONTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
604 CHOCTAW ST, ALVA, OK 73717-1626
(580) 327-1112
Mailing address
604 CHOCTAW ST, ALVA, OK 73717-1626
(580) 327-1112
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
200065
OK
Other
Enumeration date
05/27/2021
Last updated
05/27/2021
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