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Individual

MR. ALLEN LEE WEBSTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1322 W MAIN ST, ANTLERS, OK 74523-2016
(580) 298-5062
(580) 298-9958
Mailing address
1322 W MAIN ST, ANTLERS, OK 74523-2016
(580) 298-5062
(580) 298-9958

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200111200A
OK
Enumeration date
01/03/2012
Last updated
01/03/2012
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