Individual
TONYA SAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 S TREATY RD, MIAMI, OK 74354-5326
(918) 540-1511
(918) 542-7374
Mailing address
114 W DELAWARE AVE, NOWATA, OK 74048-2601
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/31/2007
Last updated
08/31/2007
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