Individual
MONTANA PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 S HARRILL AVE, WAGONER, OK 74467-5317
(918) 485-0204
Mailing address
109 S HARRILL AVE, WAGONER, OK 74467-5317
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1154000925
OK
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
07/17/2023
Last updated
10/19/2023
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