Individual
MRS. ANDREA BOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
128 N 12TH AVE, DURANT, OK 74701-4718
(580) 745-9276
Mailing address
16980 RAINBOW LN, MADILL, OK 73446-3075
(580) 371-1894
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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