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Steven Graham Shackelford

Case Manager/Care Coordinator in Grove, OK. Individual provider (NPI-1).

NPI number1497399331
StatusActive
Last updated in NPPESNov 4, 2019

Details

NPI
1497399331
Entity type
Individual (NPI-1)
Name
Steven Graham Shackelford
Sex
Male
Sole proprietor
No
Enumeration date
Nov 4, 2019
Last updated
Nov 4, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171M00000X Case Manager/Care Coordinator––Yes

Practice location

1115 Harbor Rd
Grove, OK 74344-3505

Phone 918-786-4434 · Fax 918-786-4435

Mailing address

1115 Harbor Rd
Grove, OK 74344-3505

Phone 918-786-4434 · Fax 918-786-4435

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