LISTA MARIE DALLIS

TAHLEQUAH, OK
NPI1104468610
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: OK  99753)
Enumeration Date2019-10-16
Last Update Date2022-02-17
Business Address
LISTA MARIE DALLIS
1500 E DOWNING ST STE 214
TAHLEQUAH, OK 74464-3379
Phone number: 918-413-0202
Mailing Address
LISTA MARIE DALLIS
PO BOX 751
HULBERT, OK 74441-0751
Phone number: 187-723-3990
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