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1033518873
MELISSA ELLIS
WAGONER, OK
NPI
1033518873
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2014-08-18
Last Update Date
2018-08-29
Business Address
MELISSA ELLIS
2109 S HIGHWAY 69
WAGONER, OK 74467
Phone number: 918-342-0770
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Mailing Address
MELISSA ELLIS
2109 S HIGHWAY 69
WAGONER, OK 74467-9310
Phone number: 918-342-0770
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