Individual
CLAYTON BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2221 W DETROIT ST, BROKEN ARROW, OK 74012-3628
(918) 615-6492
Mailing address
4621 W TOLEDO ST, BROKEN ARROW, OK 74012-5972
(661) 477-1658
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
CF393
OK
Other
Enumeration date
08/09/2018
Last updated
08/25/2021
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