Individual
CHARLI ANGELIC RIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
606 KIHEKAH AVE, PAWHUSKA, OK 74056-4225
(918) 287-5413
(918) 287-5234
Mailing address
606 KIHEKAH AVE, PAWHUSKA, OK 74056-4225
(918) 287-5413
(918) 287-5234
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/02/2018
Last updated
02/02/2018
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