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Individual

MR. AUSTIN CLAY WHITEFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
511 N MONTE VISTA ST, ADA, OK 74820-4611
(580) 436-3633
Mailing address
511 N MONTE VISTA ST, ADA, OK 74820-4611
(580) 436-3633

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2098
OK

Other

Enumeration date
11/03/2011
Last updated
11/03/2011
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