Individual
SHERMOAN RODERICK DAIYAAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 200-6856
Mailing address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 200-6856
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/26/2024
Last updated
01/30/2024
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