Individual
KAMRON MANOUCHEHR FAKHRSHAFAEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 W. BROADWAY, THOMAS, OK 73669
(580) 661-3488
(580) 661-3488
Mailing address
11520 CEDAR VALLEY DR, OKLAHOMA CITY, OK 73170
(405) 761-5575
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/24/2023
Last updated
02/24/2023
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