JEFFREY MICHAEL LAKE

VINITA, OK
NPI1316432115
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy175T00000X Peer Specialist
Enumeration Date2018-06-25
Last Update Date2018-07-30
Business Address
JEFFREY MICHAEL LAKE
405 E EXCELSIOR AVE
VINITA, OK 74301
Phone number: 918-256-6476
Mailing Address
JEFFREY MICHAEL LAKE
405 E EXCELSIOR AVE
VINITA, OK 74301-4226
Phone number: 918-256-6476
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