MEDICARE: MS. GLENNA J FRAWNER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	27	OK
2	335E00000X	Prosthetic/Orthotic Supplier	20	OK

General Provider Information

NPI Number	:	1508065756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GLENNA J FRAWNER

Provider Business Mailing Address
First Line	:	8121 S WESTERN AVE STE H
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-2546
Country	:	US
Telephone Number	:	405-550-3922
Fax Number	:

Provider Business Practice Location Address
First Line	:	8121 S WESTERN AVE STE H
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-2546
Country	:	US
Telephone Number	:	405-550-3922
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2007
Last Update Date	:	07/17/2007

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