Individual
PEDRO CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2315 SW H AVE, APT 102, LAWTON, OK 73505-8141
(580) 647-9402
Mailing address
2315 SW H AVE, APT 102, LAWTON, OK 73505-8141
(580) 647-9402
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/26/2013
Last updated
07/26/2013
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