Most Relevant Information
Provider Data
| NPI Number: | 1003216920 |
| Provider Name: | LISA BANKS |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/27/2014 |
| Last Updated: | 08/27/2014 |
Provider Practice Location
1624 GREENBRIAR PL
SUITE 300
OKLAHOMA CITY
OK
731597663
Practice Location Phone/Fax
| Phone: | 4055017942 |
| Fax: |
Provider Mailing Location
501 S 4TH ST
MCLOUD
OK
748518111
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |