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1114448917
LACEY POTTER
ADA, OK
NPI
1114448917
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2017-06-30
Last Update Date
2017-06-30
Business Address
LACEY POTTER
15881 COUNTY ROAD 3590
ADA, OK 74820-0483
Phone number: 580-235-3138
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Mailing Address
LACEY POTTER
PO BOX 715
ADA, OK 74821-0715
Phone number: 580-235-3138
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