Individual
BRENT ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
502 E 4TH ST, CLAREMORE, OK 74017-8436
(918) 404-9906
Mailing address
502 E 4TH ST, CLAREMORE, OK 74017-8436
(918) 404-9906
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/27/2019
Last updated
06/27/2019
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