Individual
TANDY LEAH LOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
117 EAST MAIN, HUGO, OK 74743
(580) 326-7477
Mailing address
HC 67 BOX 210, ANTLERS, OK 74523
(580) 298-7499
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100750190
—
OK
Enumeration date
06/30/2011
Last updated
06/30/2011
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