Individual
MRS. MELANIE JANE WHEAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
34183 COUNTRY CLUB LN, POTEAU, OK 74953-9122
(918) 649-7641
Mailing address
117 REDBUD LN, POTEAU, OK 74953-2041
(918) 649-7766
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200289470A
—
OK
Enumeration date
04/16/2013
Last updated
04/16/2013
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