Heaven Lax

NPI #1992355994 in Muskogee, Oklahoma

Provider Information

NPI Number: 1992355994
Entity Type: Individual
Name: Heaven Lax
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Sep 12, 2019
Last Updated: Sep 12, 2019

Practice Location

Address: 1229 LIVE OAK ST
City: Muskogee
State: Oklahoma
ZIP Code: 74403-2542
Phone: (918) 360-9913

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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