IndividualActive
Derry Hallmark
NPI 1699174284 · Substance Abuse Rehabilitation Facility · Canadian, OK
Provider details
- NPI number
- 1699174284
- Entity type
- Individual
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Residential Treatment Facilities
Practice location
69 Arrowhead Loop
Canadian, OK 74425-5012
Phone: (918) 339-5800
Fax: (918) 339-5832
Approximate (ZIP-level) locationGet directions
Mailing address
69 Arrowhead Loop
Canadian, OK 74425-5012
Registry dates
- Enumerated
- 2014-08-19
- Last updated
- 2014-08-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.