Individual
MR. BRIAN CHARLES CAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1239 S QUINCY AVE APT 16, TULSA, OK 74120-5277
(918) 764-0662
Mailing address
1239 S QUINCY AVE APT 16, TULSA, OK 74120-5277
(918) 764-0662
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/20/2021
Last updated
02/20/2021
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