Individual
PAUL NATHANIEL LASITER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 STANTON L YOUNG BLVD, OKLAHOMA CITY, OK 73104-5018
(405) 271-2316
Mailing address
18904 SHILSTONE WAY, EDMOND, OK 73012-8907
(405) 802-6235
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
—
OK
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/17/2022
Last updated
08/17/2022
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