Provider Information for 1093027849
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ASHLEY QUEEN
Sex: Female
NPI: 1093027849
Last Updated: 2010-07-09
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1093027849 | ||||||||
| Enumeration Date | 2010-07-09 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1213 N HARVEY AVE APT 4 OKLAHOMA CITY, OK 73103-3733 United States Phone: 405-473-6245 | Fax: | ||||||||
| Primary Practice Address | 1213 N HARVEY AVE APT 4 OKLAHOMA CITY, OK 73103-3733 United States Phone: 405-473-6245 | Fax: | ||||||||
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