Individual
BONNIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
213 W BROADWAY AVE, ELK CITY, OK 73644-4741
(580) 303-8806
Mailing address
PO BOX 2053, ELK CITY, OK 73648-2053
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/27/2016
Last updated
12/27/2016
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