Individual
MANDY BOTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
511 E 2ND ST, HEAVENER, OK 74937-3419
(918) 653-7718
(918) 653-7279
Mailing address
PO BOX 579, MCALESTER, OK 74502-0579
(918) 426-7800
(918) 426-5837
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
R0123711
OK
Other
Enumeration date
10/06/2025
Last updated
10/06/2025
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