Provider Demographics
NPI:1376802991
Name:MCNALLY, JANET LOUISE (BS)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LOUISE
Last Name:MCNALLY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1726 NW LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73507-5122
Mailing Address - Country:US
Mailing Address - Phone:580-351-1767
Mailing Address - Fax:
Practice Address - Street 1:1726 NW LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73507-5122
Practice Address - Country:US
Practice Address - Phone:580-351-1767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor