Individual
CHARLES DEWAYNE POOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCP
Contact information
Practice address
3601 N MAY AVE, SUITE C, OKLAHOMA CITY, OK 73112-6641
(405) 604-5613
(405) 601-3750
Mailing address
3601 N MAY AVE, SUITE C, OKLAHOMA CITY, OK 73112-6641
(405) 604-5613
(405) 601-3750
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
LP 24
OK
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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