Provider Information for 1447617964
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MARISSA SAVALA
Sex: Female
NPI: 1447617964
Last Updated: 2016-01-28
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1447617964 | ||||||||
| Enumeration Date | 2016-01-28 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1805 N YORK ST STE G MUSKOGEE, OK 74403-1442 United States Phone: 918-682-9292 | Fax:918-682-0054 | ||||||||
| Primary Practice Address | 1805 N YORK ST STE G MUSKOGEE, OK 74403-1442 United States Phone: 918-682-9292 | Fax:918-682-0054 | ||||||||
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