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FNU MANTAN TANGHAM EPSE FOMUNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10009 SENATE DR, OKLAHOMA CITY, OK 73162-7524
(405) 410-8766
Mailing address
10009 SENATE DR, OKLAHOMA CITY, OK 73162-7524
(405) 410-8766

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0114467
OK

Other

Enumeration date
03/25/2017
Last updated
03/25/2017
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