Individual
MR. LUPE NICHOLAS VIDAURRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.A. CRIMINAL JUSTIC
Contact information
Practice address
703 FRISCO AVE, CLINTON, OK 73601-3320
(580) 323-9100
Mailing address
703 FRISCO AVE, CLINTON, OK 73601-3320
(580) 323-9100
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/25/2011
Last updated
04/25/2011
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