Individual
DORIS CHANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
308 W 4TH ST, KONAWA, OK 74849-1612
(580) 925-3618
Mailing address
PO BOX 31, KONAWA, OK 74849-0031
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/26/2011
Last updated
09/26/2011
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