Individual
MR. SAMMY CLARENCE LOOKOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1011 GRANDVIEW AVE, PAWHUSKA, OK 74056-3023
(918) 287-5417
(918) 287-3721
Mailing address
1011 GRANDVIEW AVE, PAWHUSKA, OK 74056-3023
(918) 287-5417
(918) 287-3721
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/27/2012
Last updated
08/27/2012
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