Individual
MRS. TAMMY RALENE BOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BHRS
Contact information
Practice address
401 N CHURCH ST, POTEAU, OK 74953-3502
(918) 649-0230
(918) 649-1492
Mailing address
PO BOX 1030, ANTLERS, OK 74523-1030
(580) 298-2830
(580) 298-6723
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E00008053
—
OK
Enumeration date
07/02/2012
Last updated
01/11/2013
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