Individual
TINA MARIE WAINWRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A-C
Contact information
Practice address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3286
(580) 925-9149
Mailing address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3286
(580) 925-9149
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2109
OK
Other
Enumeration date
03/01/2012
Last updated
03/01/2012
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