Individual
CARMIN TECUMSEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHR
Contact information
Practice address
1803 S WOOD DR, OKMULGEE, OK 74447-6825
(918) 752-9024
Mailing address
1803 S WOOD DR, OKMULGEE, OK 74447-6825
(918) 752-9024
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100734620
—
OK
Enumeration date
01/03/2011
Last updated
01/03/2011
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