NPI 1013577139
Justin Lynn Cicotte
Practice location
- Address
- 405 E Excelsior Ave, Vinita, OK 74301-4226
- Phone
- (918) 256-6476
- Fax
- (918) 256-9890
- Mailing address
- 404 E. Excelsior Ave., Vinita, OK 74301
Registered specialties
Peer Specialist
Primary
Registry record
- NPI
- 1013577139
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 20 Jun 2019
- Record last updated
- 24 Nov 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.