Individual
MISS FERRELL LACE BALENTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.A.
Contact information
Practice address
203 MILLS AVE, POTEAU, OK 74953-2737
(918) 721-8197
Mailing address
203 MILLS AVE, 203 MILLS AVE, POTEAU, OK 74953-2737
(918) 721-8197
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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