Individual
MR. BENJAMIN GRADY WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
312 CHAPMAN STREET, TALIHINA, OK 74571
(918) 917-3350
Mailing address
PO BOX 154, TALIHINA, OK 74571-0154
(918) 917-3350
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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