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Individual

TERESA ANN ATWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
620 E COURT ST, ATOKA, OK 74525-3016
(580) 364-0170
Mailing address
302 W 1ST ST, ATOKA, OK 74525-2206
(580) 364-3348

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
02/23/2011
Last updated
10/15/2012
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