Individual
CHARITY EIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
142 W MAIN ST, DURANT, OK 74701-5008
(580) 920-2069
(580) 920-1010
Mailing address
142 W MAIN ST, DURANT, OK 74701-5008
(580) 920-2069
(580) 920-1010
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/25/2011
Last updated
01/25/2011
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