Individual
MATTHEW SULLIVAN IVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4436 NW 50TH ST, OKLAHOMA CITY, OK 73112-2212
(405) 858-2700
Mailing address
4436 NW 50TH ST, OKLAHOMA CITY, OK 73112-2212
(405) 858-2700
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/15/2007
Last updated
07/08/2007
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