Individual
BAILEY LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 N 4TH ST, PONCA CITY, OK 74601-4527
(515) 745-6315
Mailing address
305 N 11TH ST, PONCA CITY, OK 74601-4742
(515) 745-8385
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/04/2018
Last updated
12/04/2018
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