Individual
CHANDRA FAZEKAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 E MAIN ST, SUITE 3, WILBURTON, OK 74578-4415
(918) 465-6462
Mailing address
301 E MAIN ST, SUITE 3, WILBURTON, OK 74578-4415
(918) 465-6462
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/04/2015
Last updated
06/04/2015
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