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1144982604
TYLER LEE JOHNSON-ROOT
VINITA, OK
NPI
1144982604
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2021-10-12
Last Update Date
2021-10-12
Business Address
TYLER LEE JOHNSON-ROOT
405 E EXCELSIOR AVE
VINITA, OK 74301-4226
Phone number: 918-256-6476
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Mailing Address
TYLER LEE JOHNSON-ROOT
405 E EXCELSIOR AVE
VINITA, OK 74301-4226
Phone number: 918-256-6476
Copy
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