Individual
MICHAEL WAYNE CRISWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2808 NW 31ST ST, OKLAHOMA CITY, OK 73112-7407
(405) 848-7555
Mailing address
2413 NW 21ST ST, OKLAHOMA CITY, OK 73107-3221
(405) 476-3748
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/21/2021
Last updated
04/21/2021
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