Individual
CHARLES HENRY MATLOCK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
172 GREENWOOD AVE, MANNFORD, OK 74044-3447
(918) 865-4141
Mailing address
29833 E 155TH ST S, COWETA, OK 74429-6016
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/04/2026
Last updated
08/04/2026
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