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Individual

MRS. LOIS ANN UMDENSTOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
6136 S FULTON AVE, TULSA, OK 74136-2007
(918) 493-1618
Mailing address
6136 S FULTON AVE, TULSA, OK 74136-2007
(918) 493-1618

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
OT361
OK

Other

Enumeration date
03/23/2007
Last updated
07/09/2007
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