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Individual

MRS. ALTIS BEATRICE RUTHERFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BA,BHRS, CM-A

Contact information

Practice address
300 N DALTON, VALLIANT, OK 74764
(580) 286-6638
(580) 286-5206
Mailing address
PO BOX 673, VALLIANT, OK 74764-0673
(580) 933-7031
(580) 933-7034

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
03/06/2007
Last updated
09/22/2011
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