SHANE LIETCH

EDMOND, OK
NPI1295276731
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy175T00000X Peer Specialist
Additional Taxonomies171M00000X Case Manager/Care Coordinator
Enumeration Date2017-03-16
Last Update Date2022-04-18
Business Address
Mr. SHANE LIETCH
609 ROLLING HILLS TER
EDMOND, OK 73012-6611
Phone number: 405-588-2356
Mailing Address
Mr. SHANE LIETCH
11998 E 223RD ST S
PORUM, OK 74455-4081
Phone number: 405-588-2356
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