Individual
SANDRA AILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
827 E HUBBARD RD, PONCA CITY, OK 74601-1073
(580) 762-3217
(580) 762-3224
Mailing address
827 E HUBBARD RD, PONCA CITY, OK 74601-1073
(580) 762-3217
(580) 762-3224
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
46116
OK
Other
Enumeration date
11/13/2020
Last updated
11/13/2020
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