| Provider / Organization | NPI | Date Certified |
|---|---|---|
| DAVID LEE LOUGHRIDGE | 1255098554 | 2021-11-21 |
David Lee Loughridge is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1255098554. Registration indicates David Lee Loughridge is a provider of services with a specialization in Other Service Providers, Case Manager/Care Coordinator (Case Manager/Care Coordinator, ) (All Other Specialties & Provider Types, ) (Case Manager/Care Coordinator, Other Service Providers)
| Entity Type | Individual |
| Provider Name | David Lee Loughridge |
| Practice Office Address | 301 W MAIN ST ARDMORE, OK US |
| Practice Office Telephone | 4053068511 |
| Mailing Address | 202 S WASHITA AVE WYNNEWOOD, OK 730987820 US |
| Business Telephone | 4056654385 |
| Code | Practice | License No State |
|---|---|---|
| 171M00000X PRIMARY | Other Service Providers Case Manager/Care Coordinator Case Manager/Care Coordinator All Other Specialties & Provider Types Case Manager/Care Coordinator Other Service Providers |