Individual
CARI CHRISTINE MEDDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
804 KEITHAN ST, BROKEN BOW, OK 74728-2728
(580) 236-2210
Mailing address
804 KEITHAN ST, BROKEN BOW, OK 74728-2728
(580) 236-2210
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
082034941
OK
Other
Enumeration date
10/19/2011
Last updated
10/19/2011
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