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General NPI Number Information
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NPI Number | 1861158446
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Entity Type | Individual
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Provider Name | ABBAGALE BOND
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Gender | Female
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Dates
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Enumeration Date | 11/09/2021
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | OSU COLLEGE OF OSTEOPATHIC MEDICINE 1111 W 1
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City | TULSA
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State | OK
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Zip | 74107-7410
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Country | US
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Telephone | 580-650-8560
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Fax |
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Provider Business Mailing Address
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Address Line | 305 N MAIN ST APT 212
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City | BROKEN ARROW
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State | OK
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Zip | 74012-3966
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Country | US
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Telephone | 580-650-8560
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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