Individual
CHARLES NIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C. CANDIDATE
Contact information
Practice address
106 N 5TH ST, PONCA CITY, OK 74601-4535
(580) 242-4673
Mailing address
106 N 5TH ST, PONCA CITY, OK 74601-4535
(580) 242-4673
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/05/2014
Last updated
11/05/2014
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