Individual
CHAD KILLS CROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAED
Contact information
Practice address
620 W GRAND AVE, PONCA CITY, OK 74601-5123
(580) 762-1462
(580) 765-7299
Mailing address
620 W GRAND, PONCA CITY, OK 74601
(580) 762-1462
(580) 762-7299
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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