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Individual

MRS. AINSLEY JALAYNE WATTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
301 N HIGH ST, ANTLERS, OK 74523-2238
(580) 271-1638
Mailing address
301 N HIGH ST, ANTLERS, OK 74523-2238
(580) 271-1638

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
OK

Other

Enumeration date
07/09/2018
Last updated
07/09/2018
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