Individual
DEVON PEDERSEN-DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 256-6476
(918) 256-3628
Mailing address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 256-6476
(918) 256-3628
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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