Individual
MR. LARRY DOUGLAS GERKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1316 E JACKSON AVE N, SAPULPA, OK 74066-3752
(918) 724-1963
Mailing address
1316 E JACKSON AVE N, SAPULPA, OK 74066-3752
(918) 724-1963
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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