Individual
BETRAND F FONSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8915 S OLIE AVE, OKLAHOMA CITY, OK 73139-9317
(405) 768-4024
Mailing address
8320 NW 151ST TER, EDMOND, OK 73013-8985
(405) 315-2115
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/02/2025
Last updated
08/12/2025
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