Individual
JOSUE SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1303 W GORE BLVD, LAWTON, OK 73501-3645
(580) 512-0193
(866) 292-0710
Mailing address
1303 W GORE BLVD, LAWTON, OK 73501-3645
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/23/2019
Last updated
05/23/2019
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