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Individual

MR. MALCOLM GENE HARDAGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
15061 E 181ST ST S, BIXBY, OK 74008-9340
(918) 724-0901
Mailing address
15061 E 181ST ST S, BIXBY, OK 74008-9340
(918) 724-0901

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
10/29/2013
Last updated
10/29/2013
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