Individual
BREENE AUDREY LYNN MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5300 N MERIDIAN AVE STE 6, OKLAHOMA CITY, OK 73112-2137
(405) 441-5641
Mailing address
1200 KELLY PARK RD, EDMOND, OK 73003-5850
(405) 441-5641
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
197844
OK
Other
Enumeration date
02/23/2024
Last updated
02/23/2024
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