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Individual

JAMES CLARE II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
420 W BROADWAY ST, MUSKOGEE, OK 74401-6613
(918) 681-4201
Mailing address
205 PHOENIX VILLAGE RD, MUSKOGEE, OK 74403-6206
(918) 315-4744

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200314030B
OK
Enumeration date
12/08/2014
Last updated
12/08/2014
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