NPI 1598166803
Mwindaace Davis
Practice location
- Address
- 3304 W Galveston Pl, Broken Arrow, OK 74012-3255
- Phone
- (918) 277-9744
Registered specialties
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
Registry record
- NPI
- 1598166803
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 7 Sep 2014
- Record last updated
- 7 Sep 2014
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.