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NPI Code Detail

MEDICARE: DENA PACE

MEDICARE: DENA PACE
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1811446099
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENA PACE
Provider Business Mailing Address
First Line : 1108 N WHEELER AVE
Second Line :
City : SALLISAW
State : OK
Zip : 74955-2227
Country : US
Telephone Number : 918-775-5513
Fax Number : 918-775-5526
Provider Business Practice Location Address
First Line : 1108 N WHEELER AVE
Second Line :
City : SALLISAW
State : OK
Zip : 74955-2227
Country : US
Telephone Number : 918-775-5513
Fax Number : 918-775-5526
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2016
Last Update Date : 09/28/2016

Similar Medicare Providers

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Directions to “ DENA PACE ” Practice Location

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