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1104351709
JACOB ANDERSON
DURANT, OK
NPI
1104351709
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2017-04-21
Last Update Date
2017-04-21
Business Address
Mr. JACOB ANDERSON
142 W MAIN ST
DURANT, OK 74701-5008
Phone number: 580-920-2069
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Mailing Address
Mr. JACOB ANDERSON
142 W MAIN ST
DURANT, OK 74701-5008
Phone number: 580-920-2069
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