Individual
BRANDI S BURKHALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1327 N 16TH AVE, DURANT, OK 74701-2134
(580) 931-9064
Mailing address
PO BOX 937, CALERA, OK 74730-0937
(918) 200-5765
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200287120A
—
OK
Enumeration date
11/05/2012
Last updated
11/05/2012
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