Individual
MONA J DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4103 S YALE AVE STE B, TULSA, OK 74135-6002
(183) 827-3009
Mailing address
607 W AUDD AVE, CHECOTAH, OK 74426-4615
(918) 281-9820
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0045056
OK
Other
Enumeration date
02/19/2024
Last updated
02/19/2024
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