TERRIE LEE WAGONER

TULSA, OK
NPI1194849919
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: KS  OA310)
Enumeration Date2007-03-19
Last Update Date2007-07-08
Business Address
-- TERRIE LEE WAGONER COTA
6202 E 61ST ST
TULSA, OK 74136-2119
Phone number: 918-477-7171
Mailing Address
-- TERRIE LEE WAGONER COTA
PO BOX 831
MADILL, OK 73446-0831
Phone number: 580-795-3301
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