Mandi Faddis

NPI #1912454075 in Stilwell, Oklahoma

Provider Information

NPI Number: 1912454075
Entity Type: Individual
Name: Mandi Faddis
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Technician, Other
Enumeration Date: Sep 7, 2016
Last Updated: Sep 7, 2016

Practice Location

Address: RT 3 BOX 2510
City: Stilwell
State: Oklahoma
ZIP Code: 74960
Phone: (918) 723-3181

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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