Most Relevant Information
Provider Data
| NPI Number: | 1003180068 |
| Provider Name: | WENDY RENEE BURG |
| Entity Type: | Individual |
| Taxonomy Code: | 251S00000X |
| Specialty: | Community/Behavioral Health |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/07/2012 |
| Last Updated: | 03/07/2012 |
Provider Practice Location
1700 HOLBROOK ST
PONCA CITY
OK
746043809
Practice Location Phone/Fax
| Phone: | 5807163411 |
| Fax: |
Provider Mailing Location
1700 HOLBROOK ST
PONCA CITY
OK
746043809
Provider Mailing Phone/Fax
| Phone: | 5807163411 |
| Fax: |