Individual
KEITH MICHAEL WEAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., A.T.C., L.A.T.
Contact information
Practice address
709 OKLAHOMA BLVD, ALVA, OK 73717-2749
(580) 327-8627
Mailing address
524 MIMOSA DR, ALVA, OK 73717-3330
(208) 596-8864
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
904
OK
Other
Enumeration date
10/22/2014
Last updated
06/28/2023
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