Individual
DONNELLE D LISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4605 N MACARTHUR BLVD, WARR ACRES, OK 73122-5009
(405) 498-3341
Mailing address
433 NW 25TH ST APT 11, OKLAHOMA CITY, OK 73103-1528
(580) 682-1714
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
04/01/2019
Last updated
04/01/2019
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