Individual
NICHOLAS JAY LIVINGSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15939 SW LEE BLVD, CACHE, OK 73527-3027
(580) 699-0295
Mailing address
15939 SW LEE BLVD, CACHE, OK 73527-3027
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/30/2012
Last updated
07/20/2015
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