Individual
MS. GINNY LANELL WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18414 S HWY 75, MOUNDS, OK 74047-4711
(918) 827-3106
Mailing address
18414 S HWY 75, MOUNDS, OK 74047-4711
(918) 827-3106
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
200024480-A
OK
174400000X
Specialist
Primary
200024480B
OK
174400000X
Specialist
200024480C
OK
Other
Enumeration date
05/11/2007
Last updated
07/08/2007
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