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Individual

OTIS ROSS GATEWOOD III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BSBHRS

Contact information

Practice address
3501 E GORE BLVD APT 1218, LAWTON, OK 73501-6861
(405) 370-2448
Mailing address
3501 E GORE BLVD APT 1218, LAWTON, OK 73501-6861
(405) 370-2448

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

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