Individual
MICHAEL ASHLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
213 FIRST STREET, WANN, OK 74083
(620) 330-7639
(620) 330-7639
Mailing address
PO BOX 133, WANN, OK 74083-0133
(620) 330-7639
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1871478107
OK
Other
Enumeration date
08/06/2025
Last updated
12/13/2025
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