Individual
DOROTHY WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
304 SUMMIT ST, MARIETTA, OK 73448-1829
(580) 276-3853
Mailing address
304 SUMMIT ST, MARIETTA, OK 73448-1829
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/27/2019
Last updated
09/27/2019
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