MR. Ricardo Medina SR.

NPI #1629526355 in Miami, Oklahoma

Provider Information

NPI Number: 1629526355
Entity Type: Individual
Name: MR. Ricardo Medina SR.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Enumeration Date: Sep 11, 2016
Last Updated: Sep 14, 2016

Practice Location

Address: 111 S TREATY RD
City: Miami
State: Oklahoma
ZIP Code: 74354-5327
Phone: (918) 540-1522

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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