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1003180068
WENDY RENEE BURG
PONCA CITY, OK
NPI
1003180068
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
251S00000X
Enumeration Date
2012-03-07
Last Update Date
2012-03-07
Business Address
-- WENDY RENEE BURG
1700 HOLBROOK ST
PONCA CITY, OK 74604-3809
Phone number: 580-716-3411
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Mailing Address
-- WENDY RENEE BURG
1700 HOLBROOK ST
PONCA CITY, OK 74604-3809
Phone number: 580-716-3411
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