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General NPI Number Information
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NPI Number | 1215050240
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Entity Type | Organization
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Legal Business Name | GOLDEN RULE INDUSTRIES OF MUSKOGEE
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2022 W SHAWNEE ST
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City | MUSKOGEE
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State | OK
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Zip | 74401-2222
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Country | US
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Telephone | 918-683-5505
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Fax | 918-683-4714
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Provider Business Mailing Address
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Address Line | 2022 W SHAWNEE ST
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City | MUSKOGEE
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State | OK
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Zip | 74401-2222
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Country | US
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Telephone | 918-683-5505
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Fax | 918-683-4714
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MARSHALL CLAYTON
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Credential |
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Telephone | 918-683-5505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State | OK
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