Individual
BRIAN ALAN MIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2874 S OAK TREE LN, ATOKA, OK 74525-5434
(580) 239-1735
Mailing address
2874 OAK TREE LANE, ATOKA, OK 74525
(580) 239-1735
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/18/2017
Last updated
10/18/2017
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