Individual
ISAAC AINSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6510 S WESTERN AVE STE 400, OKLAHOMA CITY, OK 73139-1712
(405) 634-1497
(405) 634-1919
Mailing address
6510 S WESTERN AVE STE 400, OKLAHOMA CITY, OK 73139-1712
(405) 634-1497
(405) 634-1919
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
K083330874
OK
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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