Individual
MIKE MCCONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
212 W DOGWOOD DR, POND CREEK, OK 73766-9783
(580) 231-5070
Mailing address
212 W DOGWOOD DR, POND CREEK, OK 73766-9783
(580) 231-5070
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
374U00000X
Home Health Aide
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/16/2008
Last updated
05/15/2015
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