Individual
MATHEW DAVID RIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13707 FAIRHILL AVE, EDMOND, OK 73013-1946
(405) 607-4041
Mailing address
13707 FAIRHILL AVE, EDMOND, OK 73013-1946
(405) 607-4041
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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