BAOLONG DO

GUYMON, OK
NPI1891338059
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: OK  134792)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: KS  53-79076-102)
Enumeration Date2019-10-21
Last Update Date2019-12-27
Business Address
BAOLONG DO
123 MEDICAL DR
GUYMON, OK 73942-3606
Phone number: 580-338-3361
Mailing Address
BAOLONG DO
PO BOX 1340
LIBERAL, KS 67905-1340
Phone number: 620-629-6638
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