Individual
MR. DAVID BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSRS
Contact information
Practice address
1322 W MAIN ST, ANTLERS, OK 74523-2016
(580) 298-5062
(580) 298-9958
Mailing address
1322 W MAIN ST, ANTLERS, OK 74523-2016
(580) 298-5062
(580) 298-9958
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200111200A
—
OK
Enumeration date
08/05/2011
Last updated
08/05/2011
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