Individual
MRS. AHONESTI RACHELLE MALLORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
594 EAGLE POINT RD, LANGLEY, OK 74350-0032
(918) 934-4863
Mailing address
PO BOX 32, STRANG, OK 74367-0032
(918) 934-4863
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0066111
OK
Other
Enumeration date
01/18/2024
Last updated
01/18/2024
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