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1083923213
MARTIN MAYTUBBY
ARDMORE, OK
NPI
1083923213
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
324500000X Substance Abuse Rehabilitation Facility
(Licence: OK 821)
Enumeration Date
2010-10-05
Last Update Date
2011-10-14
Business Address
MARTIN MAYTUBBY
9 10TH AVE NW
ARDMORE, OK 73401-5929
Phone number: 580-226-1656
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Mailing Address
MARTIN MAYTUBBY
9 10TH AVE NW
ARDMORE, OK 73401-5929
Phone number: 580-226-1656
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