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1740751916
WILDA SAMPLE
SAPULPA, OK
NPI
1740751916
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: OK 58734)
Enumeration Date
2018-12-16
Last Update Date
2018-12-16
Business Address
WILDA SAMPLE
23 E ROSS AVE
SAPULPA, OK 74066-6423
Phone number: 918-216-4999
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Mailing Address
WILDA SAMPLE
23 E ROSS AVE
SAPULPA, OK 74066-6423
Phone number:
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