TIFFANY NICOLE BANKSTON

EDMOND, OK
NPI1326295338
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant Medical
(Licence: OK  1478)
Enumeration Date2008-08-20
Last Update Date2008-08-20
Business Address
TIFFANY NICOLE BANKSTON P.A.
609 S KELLY AVE SUITE J1
EDMOND, OK 73003-5659
Phone number: 405-285-8315
Mailing Address
TIFFANY NICOLE BANKSTON P.A.
609 S KELLY AVE SUITE J1
EDMOND, OK 73003-5659
Phone number: 405-285-8315
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