Tremaine Ike Mcdonald, BHRS
Contractor in Edmond, OK. Individual provider (NPI-1).
NPI number1396006433
StatusActive
Last updated in NPPESJun 5, 2012
Details
- NPI
- 1396006433
- Entity type
- Individual (NPI-1)
- Name
- Tremaine Ike Mcdonald
- Credential
- BHRS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 5, 2012
- Last updated
- Jun 5, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171W00000X | Contractor | – | – | Yes |
Practice location
7179 Ashley TrlEdmond, OK 73025-2563
Phone 405-556-0309
Mailing address
7179 Ashley TrlEdmond, OK 73025-2563
Phone 405-556-0309
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