Individual
MR. CORTEZ DE'ANGELO EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
26243 HIGHWAY 51, WAGONER, OK 74467-8740
(918) 614-0778
Mailing address
26243 HIGHWAY 51, WAGONER, OK 74467-8740
(918) 614-0778
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/12/2017
Last updated
01/08/2019
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