Provider Demographics
NPI:1457450090
Name:SILER, ZONA MARIE
Entity Type:Individual
Prefix:
First Name:ZONA
Middle Name:MARIE
Last Name:SILER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 SW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:WAGONER
Mailing Address - State:OK
Mailing Address - Zip Code:74467-8183
Mailing Address - Country:US
Mailing Address - Phone:918-485-8910
Mailing Address - Fax:918-485-9972
Practice Address - Street 1:908 SW 21ST ST
Practice Address - Street 2:
Practice Address - City:WAGONER
Practice Address - State:OK
Practice Address - Zip Code:74467-8183
Practice Address - Country:US
Practice Address - Phone:918-485-8910
Practice Address - Fax:918-485-9972
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK177F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging