Individual
SAMUEL PETERS I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7811 NW BALDWIN AVE, LAWTON, OK 73505-2423
(580) 536-2753
Mailing address
7811 NW BALDWIN AVE, LAWTON, OK 73505-2423
(580) 536-2753
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
11/24/2015
Last updated
11/24/2015
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