Individual
GLEN DANYELL GATLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6047 SW 112TH ST, LAWTON, OK 73505-9637
(580) 591-1229
Mailing address
6047 SW 112TH ST, LAWTON, OK 73505-9637
(580) 591-1229
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
21578-P
OK
Other
Enumeration date
05/20/2022
Last updated
04/20/2025
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