Most Relevant Information
Provider Data
| NPI Number: | 1003361817 |
| Provider Name: | LADONNA PHARISS |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/22/2016 |
| Last Updated: | 08/22/2016 |
Provider Practice Location
900 W CHOCTAW AVE
CHICKASHA
OK
730182213
Practice Location Phone/Fax
| Phone: | 4052226500 |
| Fax: |
Provider Mailing Location
900 W CHOCTAW AVE
CHICKASHA
OK
730182213
Provider Mailing Phone/Fax
| Phone: | 4052226500 |
| Fax: |