Individual
SAM SHUBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6809 NW CRESTWOOD DR, LAWTON, OK 73505-1277
(580) 704-3012
Mailing address
6809 NW CRESTWOOD DR, LAWTON, OK 73505-1277
(580) 704-3012
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/10/2012
Last updated
08/10/2012
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