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Individual

MICHAEL STANDIFER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BS

Contact information

Practice address
220 VILLAGE CIR, PONCA CITY, OK 74601-4021
(580) 762-0121
Mailing address
3542 SPRINGWOOD ST APT 614, PONCA CITY, OK 74604-1632

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
301
OK

Other

Enumeration date
10/24/2022
Last updated
10/24/2022
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