Individual
CLYDE W ATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1427 SHEPPARD ST, CHICKASHA, OK 73018-5917
(405) 222-7083
Mailing address
1427 SHEPPARD ST, CHICKASHA, OK 73018-5917
(405) 222-7083
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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