Individual
TINA NAIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPTA
Contact information
Practice address
415 W 3RD ST, OKMULGEE, OK 74447-3205
(918) 758-2075
Mailing address
8930 HILLTOP RD, BEGGS, OK 74421-2018
(918) 809-0101
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
PTA870
OK
Other
Enumeration date
06/06/2015
Last updated
06/06/2015
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