Individual
RACHAEL ANN BACKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
407 W SOUTH AVE, PONCA CITY, OK 74601-6133
(918) 308-5515
(580) 749-5792
Mailing address
407 W SOUTH AVE, PONCA CITY, OK 74601-6133
(918) 308-5515
(580) 749-5792
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
08/13/2021
Last updated
12/07/2021
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