Individual
WESLEY DALE WILLBANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1601 S 74TH ST W, MUSKOGEE, OK 74401-8718
(918) 616-5333
Mailing address
1601 S 74TH ST W, MUSKOGEE, OK 74401-8718
(918) 616-5333
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0072313
OK
Other
Enumeration date
07/16/2017
Last updated
07/21/2022
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