Individual
MARCUS NEALY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7901 NE 10TH ST, A209, MIDWEST CITY, OK 73110-3600
(405) 209-5989
(866) 422-5922
Mailing address
3433 COBBLESTONE DR, SPENCER, OK 73084-3257
(405) 209-5989
(866) 422-5922
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200497040A
—
OK
Enumeration date
09/03/2013
Last updated
09/03/2013
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