Individual
MRS. TAMERA RENEA PUTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 W A AVE, RAVIA, OK 73455-0015
(580) 369-1561
Mailing address
PO BOX 15, RAVIA, OK 73455-0015
(580) 369-1561
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
37H013851108
OK
Other
Enumeration date
09/14/2011
Last updated
09/14/2011
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