Individual
LADORA FRANCES SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 256-6476
Mailing address
111 S TREATY RD, MIAMI, OK 74354-5327
(918) 231-0975
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/10/2021
Last updated
04/05/2022
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