Individual
JOANN GASTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 NE LAWRIE TATUM RD, LAWTON, OK 73507-3002
(580) 354-5000
Mailing address
1515 NE LAWRIE TATUM RD, LAWTON, OK 73507-3002
(580) 354-5000
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
50330
OK
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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