Individual
MR. NATHANIEL DALE BREWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2324 N INTERSTATE DR, NORMAN, OK 73072-2942
(405) 361-3180
Mailing address
1317 SW 116TH TER, OKLAHOMA CITY, OK 73170-4461
(405) 314-7933
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/12/2012
Last updated
12/07/2012
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