Individual
LISA HULSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
124 S BROADWAY AVE STE 200, ADA, OK 74820-5825
(580) 332-3001
Mailing address
124 S BROADWAY AVE STE 200, ADA, OK 74820-5825
(580) 332-3001
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/28/2017
Last updated
12/28/2017
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