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Individual

LISA MARCINKEVICIUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
619 N MAIN ST, MUSKOGEE, OK 74401-4431
(918) 682-8407
Mailing address
10280 W 43RD ST S, MUSKOGEE, OK 74401-8315
(918) 351-5465

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0057607
OK

Other

Enumeration date
08/07/2013
Last updated
08/07/2013
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