Individual
CORDARIS ONASSIS BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2800 WEST GORE BLVD, LAWTON, OK 73505
(318) 461-7954
Mailing address
2800 WEST GORE BLVD, LAWTON, OK 73505
(318) 461-7954
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
K083502495
OK
Other
Enumeration date
07/18/2013
Last updated
07/18/2013
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