Individual
ABBIE ETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
17 S OAK ST, SAPULPA, OK 74066-4312
(918) 224-2610
Mailing address
207 W DAVIS AVE, SAPULPA, OK 74066-5503
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3260
OK
152WC0802X
Corneal and Contact Management Optometrist
3260
OK
152WP0200X
Pediatric Optometrist
3260
OK
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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