Individual
ERIVAN LANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1300 DORCHESTER AVE, MUSKOGEE, OK 74403-5679
(918) 616-0009
Mailing address
1300 DORCHESTER AVE, MUSKOGEE, OK 74403-5679
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/29/2016
Last updated
07/29/2016
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