Bryon Keith Wade JR.

NPI #1104794973 in Pryor, Oklahoma

Provider Information

NPI Number: 1104794973
Entity Type: Individual
Name: Bryon Keith Wade JR.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Enumeration Date: Oct 24, 2025
Last Updated: Oct 24, 2025

Practice Location

Address: 109 N FAIRLAND ST
City: Pryor
State: Oklahoma
ZIP Code: 74361-4205
Phone: (918) 625-6128

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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