Individual
AUSTIN WAYNE SOMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
58 SEMINOLE TRL, SPAVINAW, OK 74366-1116
(918) 812-3994
Mailing address
58 SEMINOLE TRL, SPAVINAW, OK 74366-1116
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
H083236016
OK
Other
Enumeration date
03/06/2019
Last updated
03/06/2019
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