Individual
TRAVIS LEE WOOLRIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 S HARRILL AVE, WAGONER, OK 74467-5317
(573) 473-7504
Mailing address
2665 E ALBANY ST APT G-811, BROKEN ARROW, OK 74014-4752
(573) 473-7504
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/07/2022
Last updated
02/07/2022
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