Individual
MRS. HEATHER DAWN FUSSELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1608 MONUMENT RD, PONCA CITY, OK 74604-3523
(580) 716-1976
Mailing address
1608 MONUMENT RD, PONCA CITY, OK 74604-3523
(580) 716-1976
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/26/2017
Last updated
07/21/2022
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