NPI 1699174284

Derry Hallmark

Practitioner Substance Abuse Rehabilitation Facility Canadian, OK

Practice location

Address: 69 Arrowhead Loop, Canadian, OK 74425-5012
Phone: (918) 339-5800
Fax: (918) 339-5832

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X

Other Substance Abuse Rehabilitation Facility providers in Oklahoma →

Registry record

NPI: 1699174284
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Aug 2014
Record last updated: 19 Aug 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.