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1194972455
ROGER D. GRAY
ADA, OK
NPI
1194972455
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK 112)
Enumeration Date
2008-08-19
Last Update Date
2008-08-19
Business Address
Mr. ROGER D. GRAY LADC
605 E 12TH ST
ADA, OK 74820-6605
Phone number: 580-436-3504
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Mailing Address
Mr. ROGER D. GRAY LADC
PO BOX 2274
ADA, OK 74821-2274
Phone number: 580-436-3504
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