Individual
SHANE CHARLES CALLAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1305 S COUNTRY CLUB RD, MUSKOGEE, OK 74403-7802
(918) 682-2077
Mailing address
PO BOX 948, TAHLEQUAH, OK 74465-0948
(918) 315-4207
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/15/2025
Last updated
01/15/2025
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