MS. Lisa Larae Mcentire

NPI #1629315106 in Ardmore, Oklahoma

Provider Information

NPI Number: 1629315106
Entity Type: Individual
Name: MS. Lisa Larae Mcentire
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Jan 3, 2013
Last Updated: Jan 3, 2013

Practice Location

Address: 3120 CARTER RD
City: Ardmore
State: Oklahoma
ZIP Code: 73401-0267
Phone: (580) 221-0781

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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