Individual
SANDRA J RIDGEWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 S PECAN ST, PAULS VALLEY, OK 73075-5049
(405) 238-4130
Mailing address
PO BOX 1081, PAULS VALLEY, OK 73075-1081
(405) 238-4130
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
10/06/2021
Last updated
10/06/2021
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