Individual
RYAN AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
717B HIGHWAY 70 E, KINGSTON, OK 73439-8253
(580) 564-7308
Mailing address
3179 W DEVILS DEN RD, TISHOMINGO, OK 73460
(580) 222-9002
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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