NPI 1043614878

Keith Michael Wear, MSATCLAT

Practitioner Contractor Alva, OK

Practice location

Address: 709 Oklahoma Blvd, Alva, OK 73717-2749
Phone: (580) 327-8627
Mailing address: 524 Mimosa Dr, Alva, OK 73717-3330

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence 904 (OK)

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Registry record

NPI: 1043614878
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Oct 2014
Record last updated: 28 Jun 2023

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.