Individual
MARIAH ASHLEY FUGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N UNIVERSITY DR, EDMOND, OK 73034-5207
(405) 974-5239
Mailing address
321 SE 6TH ST, MOORE, OK 73160-6714
(405) 821-0418
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/09/2020
Last updated
07/09/2020
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