Individual
MRS. PHYLLIS R DESHAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REEGT, CNIM
Contact information
Practice address
409 E CALIFORNIA AVE, OKLAHOMA CITY, OK 73104-4224
(405) 841-7826
(405) 841-7827
Mailing address
409 E CALIFORNIA AVE, OKLAHOMA CITY, OK 73104-4224
(405) 841-7826
(405) 841-7827
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
466
OK
Other
Enumeration date
10/05/2014
Last updated
10/05/2014
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