Individual
CHASE VICKREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 N BROADWAY ST STE 100, MOORE, OK 73160-5135
(405) 990-0816
(405) 735-6116
Mailing address
201 N BROADWAY ST STE 100, MOORE, OK 73160-5135
(405) 990-0816
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/10/2022
Last updated
11/10/2022
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