Individual
PATRICIA LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2530 S COMMERCE ST, ARDMORE, OK 73401-5519
(580) 226-5048
(580) 226-3569
Mailing address
2530 S COMMERCE ST, ARDMORE, OK 73401-5519
(580) 226-5048
(580) 226-3569
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100728830
—
OK
Enumeration date
12/13/2016
Last updated
10/31/2017
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