Individual
MICHAEL BLAKE WEIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
413 CHIEF STAN WAITE DR, CATOOSA, OK 74015-2134
(539) 777-9965
Mailing address
413 CHIEF STAN WAITE DR, CATOOSA, OK 74015-2134
(539) 777-9965
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
05/13/2020
Last updated
05/13/2020
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