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Mrs. CODI NICOLE CASTLEBERRY PA

Individual Provider (NPI-1) Active

Physician Assistant

Provider Information

NPI Number
1922508266
Provider Type
Individual Provider (NPI-1)
Credentials
PA
Status
Active

Contact & Location

Address
11426 N 134TH EAST AVE, OWASSO, OK, 740554715
Phone
(918) 376-6345
Fax
(918) 376-6635

Specialties & Taxonomies

Physician Assistant Primary License: OK #2891

All Addresses

LOCATION

11426 N 134TH EAST AVE

OWASSO, OK, 740554715

(918) 376-6345

MAILING

11426 N 134TH EAST AVE

OWASSO, OK, 740554715

(918) 376-6345