Most Relevant Information
Provider Data
| NPI Number: | 1003375577 |
| Provider Name: | ALLEN SPOONER BRAUMILLER |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/14/2019 |
| Last Updated: | 03/14/2019 |
Provider Practice Location
100 S 79TH ST
BROKEN ARROW
OK
740142726
Practice Location Phone/Fax
| Phone: | 4058006303 |
| Fax: |
Provider Mailing Location
100 S 79TH ST
BROKEN ARROW
OK
740142726
Provider Mailing Phone/Fax
| Phone: | 4058006303 |
| Fax: |