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1164120549
CHANCE RAY SHADWICK
VINITA, OK
NPI
1164120549
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2023-02-15
Last Update Date
2023-02-15
Business Address
CHANCE RAY SHADWICK
405 E EXCELSIOR AVE
VINITA, OK 74301-4226
Phone number: 918-864-0706
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Mailing Address
CHANCE RAY SHADWICK
405 E EXCELSIOR AVE
VINITA, OK 74301-4226
Phone number:
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