Individual
SCOTT WILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1405 N 4TH AVE, DURANT, OK 74701-3330
(580) 745-2026
Mailing address
243 PECAN ST, DURANT, OK 74701-7364
(580) 745-2026
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
265
OK
Other
Enumeration date
06/12/2007
Last updated
07/08/2007
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