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1366635781
CARL DEWAYNE SHEPPARD
PONCA CITY, OK
NPI
1366635781
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2007-08-20
Last Update Date
2007-08-20
Business Address
-- CARL DEWAYNE SHEPPARD
1500 N 6TH ST
PONCA CITY, OK 74601-2827
Phone number: 580-762-7561
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Mailing Address
-- CARL DEWAYNE SHEPPARD
1500 N 6TH ST
PONCA CITY, OK 74601-2827
Phone number: 580-762-7561
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