Individual
SAM NIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9210 S WESTERN AVE STE A-21, OKLAHOMA CITY, OK 73139
(405) 703-8755
(405) 895-7544
Mailing address
8213 NW 8TH ST, OKLAHOMA CITY, OK 73127-4811
(405) 474-6466
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/29/2016
Last updated
08/29/2016
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