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Individual

DALAYNA DIANE FAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
14025 N EASTERN AVE, APT 3116, EDMOND, OK 73013-5588
(580) 478-3027
Mailing address
9600 BROADWAY EXT, OKLAHOMA CITY, OK 73114-7408
(580) 478-3027

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1005
OK

Other

Enumeration date
01/25/2016
Last updated
04/30/2020
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