JUSTIN BLACK

VALLIANT, OK
NPI1245969138
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: OK  1513)
Enumeration Date2022-06-07
Last Update Date2022-06-07
Business Address
JUSTIN BLACK
508 E WILSON ST
VALLIANT, OK 74764-9115
Phone number: 580-743-6553
Mailing Address
JUSTIN BLACK
404 ALLEN ST
BROKEN BOW, OK 74728-3136
Phone number: 580-306-4747
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