Individual
ANCELMA MACHADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
433 NW 68TH ST, LAWTON, OK 73505-5401
(580) 576-2318
Mailing address
433 NW 68TH ST, LAWTON, OK 73505-5401
(580) 576-2318
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
NA
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
12/20/2021
Last updated
12/20/2021
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