LANCE CORDELL JOHNSON

BETHANY, OK
NPI1275806010
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)
Enumeration Date2012-02-09
Last Update Date2012-02-09
Business Address
-- LANCE CORDELL JOHNSON
7908 NW 23RD ST
BETHANY, OK 73008-4950
Phone number: 405-636-1463
Mailing Address
-- LANCE CORDELL JOHNSON
7508 S LINN AVE
OKLAHOMA CITY, OK 73159-4612
Phone number: 405-443-1481
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