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Individual

JAMES ALLEN RATTERREE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
520 IRVING ST, FORT GIBSON, OK 74434-8873
(918) 348-6900
Mailing address
520 IRVING ST, FORT GIBSON, OK 74434-8873

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000
OK
Enumeration date
09/16/2022
Last updated
09/21/2022
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