Individual
PETRA CASTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 E GORE BLVD, LAWTON, OK 73501-6245
(580) 355-5230
(580) 585-6434
Mailing address
4400 E GORE BLVD, LAWTON, OK 73501-6245
(580) 355-5230
(580) 585-6434
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0055994
OK
Other
Enumeration date
10/02/2015
Last updated
10/02/2015
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