Individual
MRS. JANELL LUNDGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 W MAPLE ST, COLLINSVILLE, OK 74021-2326
(918) 694-4457
Mailing address
1001 W MAPLE ST, COLLINSVILLE, OK 74021-2326
(918) 694-4457
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
112
OK
Other
Enumeration date
05/01/2015
Last updated
05/01/2015
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