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1073050167
TYRON DORRELL COSBY
MOORE, OK
NPI
1073050167
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2017-01-26
Last Update Date
2017-01-26
Business Address
Mr. TYRON DORRELL COSBY
1416 PENN LN.
MOORE, OK 73160
Phone number: 405-343-3036
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Mailing Address
Mr. TYRON DORRELL COSBY
1416 PENN LN.
MOORE, OK 73160
Phone number: 405-343-3036
Copy
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