Individual
MR. JOEL HOLCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
1604 N WASHINGTON AVE, DURANT, OK 74701-2128
(580) 920-0909
Mailing address
1875 E 17TH ST, TULSA, OK 74104-5304
(918) 747-9475
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100746580 A
—
OK
Enumeration date
01/31/2010
Last updated
01/31/2010
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