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General NPI Number Information
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NPI Number | 1154137628
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Entity Type | Individual
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Provider Name | ADAM LEE QUICK
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Gender | Male
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 310 S 10TH ST
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City | HARTSHORNE
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State | OK
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Zip | 74547-4212
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Country | US
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Telephone | 918-424-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 1320 NW HOMESTEAD DR STE G
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City | LAWTON
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State | OK
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Zip | 73505-5243
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Country | US
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Telephone | 714-951-2257
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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