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1417244278
BILLY ROY CLARK
ARDMORE, OK
NPI
1417244278
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK 224)
Enumeration Date
2011-06-30
Last Update Date
2011-06-30
Business Address
Mr. BILLY ROY CLARK LADC
117 W BROADWAY ST STE 301
ARDMORE, OK 73401-6226
Phone number: 580-465-2194
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Mailing Address
Mr. BILLY ROY CLARK LADC
117 W BROADWAY ST STE 301
ARDMORE, OK 73401-6226
Phone number: 580-465-2194
Copy
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