Individual
EDDIE DUANE GAUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 W 3RD ST., APT 11, OWASSO, OK 74055
(918) 576-8005
Mailing address
110 W 3RD ST APT 11, OWASSO, OK 74055-2741
(918) 576-8005
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/01/2018
Last updated
06/01/2018
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