Individual
DR. STEPHANIE P SOUVANNACHAK-COWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
10920 S MEMORIAL DR, TULSA, OK 74133-7352
(918) 366-2020
Mailing address
113 E 125TH CT S, JENKS, OK 74037-1075
(479) 871-7525
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2954
OK
Other
Enumeration date
07/28/2017
Last updated
03/17/2018
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