Individual
DUSTY BUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1010 E WILL ROGERS BLVD, CLAREMORE, OK 74017-6352
(918) 342-3334
(918) 342-3367
Mailing address
1010 E WILL ROGERS BLVD, CLAREMORE, OK 74017-6352
(918) 342-3334
(918) 342-3367
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/20/2017
Last updated
07/21/2022
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