Individual
DR. SALLY QUE POA TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1110 N CLASSEN BLVD, SUITE 204, OKLAHOMA CITY, OK 73106-6843
(405) 319-1622
Mailing address
16804 SHORERUN DR, EDMOND, OK 73003-8431
(405) 359-6640
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19992
OK
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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