Individual
LARISSA HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
940 NE 13TH ST, OKLAHOMA CITY, OK 73104-5008
(405) 271-4417
Mailing address
940 NE 13TH ST, OKLAHOMA CITY, OK 73104-5008
(405) 271-4417
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28684
OK
Other
Enumeration date
06/13/2011
Last updated
06/16/2014
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