Individual
DANIEL ANTWAIN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MAE
Contact information
Practice address
907 W CADDO ST, CLEVELAND, OK 74020-4201
(918) 308-5511
(918) 205-2701
Mailing address
PAWNEE COUNTY 907 W. CADDO ST., CLEVELAND, OK 74020-4201
(918) 308-5511
(918) 205-2701
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
Other
Enumeration date
02/18/2014
Last updated
03/09/2022
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