Provider Demographics
NPI:1831771120
Name:RYALS, MONICA L (BS)
Entity type:Individual
Prefix:MS
First Name:MONICA
Middle Name:L
Last Name:RYALS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MRS
Other - First Name:MONICA
Other - Middle Name:L
Other - Last Name:MCCRARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:17135 N MCCRARY RD
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-1285
Mailing Address - Country:US
Mailing Address - Phone:918-525-7236
Mailing Address - Fax:
Practice Address - Street 1:17135 N MCCRARY RD
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-1285
Practice Address - Country:US
Practice Address - Phone:918-525-7236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist