Individual
MRS. ADDIE BETH GRATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
9 N MAIN ST, KINGSTON, OK 73439-6562
(580) 564-0500
(580) 564-0250
Mailing address
PO BOX 849, TISHOMINGO, OK 73460-0849
(580) 564-0500
(580) 564-0250
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
R0067529
OK
Other
Enumeration date
07/15/2006
Last updated
10/24/2017
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