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1104896760
LISA DANETTE WEST
MOORE, OK
NPI
1104896760
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: OK 1163)
Enumeration Date
2006-01-25
Last Update Date
2007-07-08
Business Address
Ms. LISA DANETTE WEST PA-C
520 S TELEPHONE RD
MOORE, OK 73160-5423
Phone number: 405-793-9355
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Mailing Address
Ms. LISA DANETTE WEST PA-C
3555 NW 58TH ST SUITE 900
OKLAHOMA CITY, OK 73112-4707
Phone number: 405-917-0418
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