Individual
MR. DAVID WAYNE EASLEY II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1300 NOLA AVE APT 12A, TAHLEQUAH, OK 74464-5252
(918) 840-6650
Mailing address
1300 NOLA AVE APT 12A, TAHLEQUAH, OK 74464-5252
(918) 840-6650
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/01/2024
Last updated
05/07/2024
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