Individual
CHARLES FIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1212 REYNOLDS AVE, POTEAU, OK 74953-4724
(918) 649-0172
Mailing address
1212 REYNOLDS AVE, POTEAU, OK 74953-4724
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OK
Other
Enumeration date
03/07/2019
Last updated
01/20/2021
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