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1164042560
CLARK R HIGGANBOTHAM
OKLAHOMA CITY, OK
NPI
1164042560
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-04-26
Last Update Date
2020-04-26
Business Address
Mr. CLARK R HIGGANBOTHAM
800 STANTON L YOUNG BLVD
OKLAHOMA CITY, OK 73104-5018
Phone number: 405-271-2316
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Mailing Address
Mr. CLARK R HIGGANBOTHAM
1701 BEDFORD DR
NICHOLS HILLS, OK 73116-5301
Phone number: 405-625-4063
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