Individual
LOUIS JAMES FAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
32018 HIGHWAY 59, MAUD, OK 74854
(405) 374-1225
Mailing address
32018 HIGHWAY 59, MAUD, OK 74854
(405) 374-1225
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/18/2021
Last updated
10/21/2021
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