Individual
CHELSEA NICOLE RENNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
407 W SOUTH AVE, PONCA CITY, OK 74601-6133
(580) 749-5056
Mailing address
407 W SOUTH AVE, PONCA CITY, OK 74601-6133
(918) 499-0649
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/08/2021
Last updated
12/20/2021
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