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Individual

BETH LEE LEADER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
603 NE 2ND ST, ROWLAND FLATT CLINIC, ANTLERS, OK 74523-2636
(580) 298-3351
(580) 298-3803
Mailing address
603 NE 2ND ST, ANTLERS, OK 74523-2636
(580) 298-3351
(580) 298-3803

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
2795
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100124300B
OK
Enumeration date
10/31/2005
Last updated
04/17/2012
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