Individual
BAYLEE MORGAN PEMBERTON- BONEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
407 W SOUTH AVE, PONCA CITY, OK 74601-6133
(918) 308-5515
Mailing address
407 W SOUTH AVE, PONCA CITY, OK 74601-6133
(918) 308-5515
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/08/2022
Last updated
03/08/2022
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