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1265202659
ANTHONY DIRTEATER
TAHLEQUAH, OK
NPI
1265202659
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2024-01-05
Last Update Date
2024-01-05
Business Address
ANTHONY DIRTEATER
113 W KEETOOWAH ST
TAHLEQUAH, OK 74464-3819
Phone number: 918-931-3700
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Mailing Address
ANTHONY DIRTEATER
113 W KEETOOWAH ST
TAHLEQUAH, OK 74464-3819
Phone number: 918-931-3700
Copy
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