Individual
JOE MCDANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1700 W BROADWAY ST, MUSKOGEE, OK 74401-3340
(918) 207-9807
Mailing address
315 ROSS AVE, FORT GIBSON, OK 74434-8522
(918) 207-9807
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
2003140308
OK
Other
Enumeration date
12/03/2013
Last updated
12/03/2013
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