Individual
MR. CLYDE RICHARD HODGES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7401 NE 23RD ST, OKLAHOMA CITY, OK 73141-1420
(405) 778-8007
Mailing address
1401 SE 19TH ST STE B, MOORE, OK 73160-7430
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/10/2020
Last updated
02/10/2020
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