Individual
NICHOLAS DWAYNE PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10306 E 114TH PL S, BIXBY, OK 74008-3205
(918) 698-6425
Mailing address
47 N BAY LN, ARDMORE, OK 73401-6592
(918) 698-6425
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/13/2019
Last updated
09/13/2019
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