Individual
AMANDA MEGAN LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14616 S NYSSA CT, GLENPOOL, OK 74033-3797
(918) 520-9114
Mailing address
14616 S NYSSA CT, GLENPOOL, OK 74033-3797
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
PENDING
OK
Other
Enumeration date
08/25/2017
Last updated
08/25/2017
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