Individual
MARY WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2957 POPLAR DR, MOORE, OK 73160-3230
(405) 410-4472
Mailing address
2957 POPLAR DR, MOORE, OK 73160-3230
(405) 410-4472
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1109
OK
Other
Enumeration date
03/30/2016
Last updated
03/30/2016
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