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General NPI Number Information
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NPI Number | 1396965075
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Entity Type | Organization
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Legal Business Name | VALERIE R HATLEY PC
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 621 W MAIN ST
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City | YUKON
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State | OK
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Zip | 73099-1035
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Country | US
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Telephone | 405-354-2788
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Fax |
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Provider Business Mailing Address
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Address Line | 621 W MAIN ST
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City | YUKON
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State | OK
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Zip | 73099-1035
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Country | US
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Telephone | 405-354-2788
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. VALERIE RIDGENA HATLEY
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Credential | OD
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Telephone | 405-354-2788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OK224
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License Number State | OK
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