Individual
WAR MALACHI X MOTHERSHED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4300 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5107
(405) 424-7711
Mailing address
1205 LAWTON AVE, MOORE, OK 73160
(405) 436-0698
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/17/2023
Last updated
10/04/2024
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