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1386774016
RUSSELL WAYNE BINGHAM
MUSKOGEE, OK
NPI
1386774016
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK 52)
Enumeration Date
2007-03-06
Last Update Date
2007-07-08
Business Address
Mr. RUSSELL WAYNE BINGHAM CADC
4009 EUFALA ST
MUSKOGEE, OK 74403
Phone number: 918-681-0484
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Mailing Address
Mr. RUSSELL WAYNE BINGHAM CADC
1203 E BROADWAY
MUSKOGEE, OK 74403
Phone number: 918-682-2841
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