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1225546534
CHRISTOPHER DEWAYNE GRANT
OKLAHOMA CITY, OK
NPI
1225546534
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK R082463502)
Enumeration Date
2018-01-21
Last Update Date
2018-01-21
Business Address
CHRISTOPHER DEWAYNE GRANT
807 NE 21ST ST
OKLAHOMA CITY, OK 73105-8213
Phone number: 318-290-9714
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Mailing Address
CHRISTOPHER DEWAYNE GRANT
807 NE 21ST ST
OKLAHOMA CITY, OK 73105-8213
Phone number: 318-290-9714
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