BLACKHAWK MANGUM, LLC
Nursing in Reed, OK

License number
Oklahoma 2208
Category
Osteopathic Medicine
Type
Emergency Medicine
License number
Oklahoma 2208
Category
Osteopathic Medicine
Type
Family Medicine
License number
Oklahoma 2208
Category
Nursing
Type
Physician Assistant
License number
Oklahoma 2208
Category
Nursing
Type
Family
Owner
Name: SHANA DAVENPORT
Title: INSURANCE CREDENTIALING SUPERVISOR
Phone: (512) 681-3460
Address
Address
One Wickersham Dr, Reed, OK 73554
National Provider ID: 1093986937
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

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