Individual
JAMES FOREMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BHRS
Contact information
Practice address
118 S MAIN ST, WAGONER, OK 74467-5221
(918) 485-1573
Mailing address
118 S MAIN ST, WAGONER, OK 74467-5221
(918) 485-1573
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/12/2014
Last updated
02/12/2014
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