LARRY CARL TUSTIN

POTEAU, OK
NPI1104145143
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2010-05-28
Last Update Date2010-05-28
Business Address
-- LARRY CARL TUSTIN BA, CADC
501 DEWEY AVE
POTEAU, OK 74953-4215
Phone number: 918-649-5035
Mailing Address
-- LARRY CARL TUSTIN BA, CADC
PO BOX 504
POTEAU, OK 74953-0504
Phone number: 918-649-5035
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