WILDSTATE LAWTON LLC

LAWTON, OK
NPI1043188261
Entity TypeOrganization
Authorized ContactCRYSTAL MICHELLE JOHNSON
Owner
580-280-2558
Organization Subpart ?Yes
Primary Taxonomy332B00000X Durable Medical Equipment & Medical Supplies
Enumeration Date2025-10-28
Last Update Date2025-11-18
Business Address
WILDSTATE LAWTON LLC
2504 SW LEE BLVD
LAWTON, OK 73505-8311
Phone number: 580-250-1999
Mailing Address
WILDSTATE LAWTON LLC
2504 SW LEE BLVD
LAWTON, OK 73505-8311
Phone number: 580-250-1999