Individual
EZEKIEL SAGE PEEVYHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
916 N MAIN ST, ALTUS, OK 73521-3118
(582) 318-9415
Mailing address
708 JUDY AVE, ALTUS, OK 73521-2327
(580) 318-9415
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-486976
OK
Other
Enumeration date
11/17/2025
Last updated
11/18/2025
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