NPI 1134534696

Shane Ethan Orr

Practitioner Student in an Organized Health Care Education/Training Program Atoka, OK

Practice location

Address: 706 S Greathouse Dr, Atoka, OK 74525
Phone: (580) 889-3553
Fax: (580) 889-4050
Mailing address: 907 W Ohio Ave, Coalgate, OK 74538-1216

Registered specialties

Student in an Organized Health Care Education/Training Program Primary

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in Oklahoma →

Registry record

NPI: 1134534696
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Jun 2014
Record last updated: 10 Aug 2015

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.