Individual
REVA D SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
604 CHOCTAW ST, ALVA, OK 73717-1626
(580) 327-1112
(580) 327-3067
Mailing address
1222 10TH ST, SUITE 211, WOODWARD, OK 73801-3156
(580) 571-3235
(580) 256-8609
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
78369
OK
Other
Enumeration date
04/15/2013
Last updated
04/15/2013
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