Individual
TRACY DEL ANGEL ISENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
706 S. GREATHOUSE DRIVE, ATOKA, OK 74525
(580) 889-3553
(580) 889-4050
Mailing address
706 S. GREATHOUSE DRIVE, ATOKA, OK 74525
(580) 889-3553
(580) 889-4050
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
731311206
—
OK
Enumeration date
10/23/2015
Last updated
10/23/2015
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