Individual
CHARLEY BOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
103 SW 2ND, PERKINS, OK 74059
(405) 547-5703
Mailing address
PO BOX 549, PERKINS, OK 74059-0549
(405) 547-5703
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
11/16/2016
Last updated
11/16/2016
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