Individual
MIRACLE METCALF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2441 NE 10TH ST APT 2, OKLAHOMA CITY, OK 73117-5045
(405) 205-4294
Mailing address
2441 NE 10TH ST APT 2, OKLAHOMA CITY, OK 73117-5045
(405) 205-4294
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
L080646455
OK
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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