DAEVA BLACC

TULSA, OK
NPI1194083600
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy104100000X Social Worker
Enumeration Date2012-05-03
Last Update Date2012-05-03
Business Address
Mr. DAEVA BLACC
3322 E 30TH ST
TULSA, OK 74114-6108
Phone number: 918-724-5680
Mailing Address
Mr. DAEVA BLACC
3322 E 30TH ST
TULSA, OK 74114-6108
Phone number: 918-724-5680
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