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Individual

BRYAN HENRY LAFUENTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CP

Contact information

Practice address
229 NW 9TH ST, SUITE 1, OKLAHOMA CITY, OK 73102-2619
(405) 974-1548
Mailing address
229 NW 9TH ST, SUITE 1, OKLAHOMA CITY, OK 73102-2619

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
OK

Other

Enumeration date
03/06/2013
Last updated
04/27/2017
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