Individual
CRYSTAL BIRCHFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 12TH AVE NW, ARDMORE, OK 73401-5736
(580) 798-4523
Mailing address
4159 MILLER DR, KINGSTON, OK 73439
(580) 564-3820
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071381109
DRIVERS LICENCE
CO
Enumeration date
09/26/2017
Last updated
09/26/2017
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