Loretta Sue Mathia

NPI #1780807354 in Grove, Oklahoma

Provider Information

NPI Number: 1780807354
Entity Type: Individual
Name: Loretta Sue Mathia
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Driver
Enumeration Date: Apr 11, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 25510 S 607 LN
City: Grove
State: Oklahoma
ZIP Code: 74344-0262
Phone: (918) 786-2908

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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