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1003660721
AMANDA IRENE EBERT
PONCA CITY, OK
NPI
1003660721
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2024-04-17
Last Update Date
2024-04-17
Business Address
AMANDA IRENE EBERT
101 WHITE EAGLE DR
PONCA CITY, OK 74601-8307
Phone number: 580-762-3421
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Mailing Address
AMANDA IRENE EBERT
101 WHITE EAGLE DR
PONCA CITY, OK 74601-8307
Phone number: 580-762-3421
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