Provider First Line Business Practice Location Address:
1222 10TH STREET, SUITE 211
Provider Second Line Business Practice Location Address:
NORTHWEST CENTER FOR BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
WOODWARD
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73801-3156
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-256-8615
Provider Business Practice Location Address Fax Number:
580-256-8643
Provider Enumeration Date:
04/18/2008