Individual
GLEN LAWTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1213 W LOUISVILLE ST, BROKEN ARROW, OK 74012-8420
(918) 258-6604
Mailing address
1213 W LOUISVILLE ST, BROKEN ARROW, OK 74012-8420
(918) 258-6604
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/08/2016
Last updated
07/08/2016
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