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Individual

BILLY GRIMES JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LADC

Contact information

Practice address
313 GAWF LN, MUSKOGEE, OK 74403-6109
(918) 289-0550
(918) 289-0551
Mailing address
313 GAWF LN, MUSKOGEE, OK 74403-6109

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
07/16/2010
Last updated
07/16/2010
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