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1366781775
ELMER SHANE FOLSTER
MANGUM, OK
NPI
1366781775
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2013-02-05
Last Update Date
2013-02-05
Business Address
-- ELMER SHANE FOLSTER BSW
2 WICKERSHAM ST
MANGUM, OK 73554-9117
Phone number: 580-782-3337
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Mailing Address
-- ELMER SHANE FOLSTER BSW
PO BOX 386
MANGUM, OK 73554-0386
Phone number: 580-782-3337
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