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1417297680
LAVINA KAY CLARK
PAWHUSKA, OK
NPI
1417297680
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
324500000X Substance Abuse Rehabilitation Facility
Enumeration Date
2013-02-25
Last Update Date
2013-02-25
Business Address
Mrs. LAVINA KAY CLARK
126 E 6TH ST
PAWHUSKA, OK 74056-4204
Phone number: 918-287-5425
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Mailing Address
Mrs. LAVINA KAY CLARK
2207 BAYLISS AVE
PAWHUSKA, OK 74056-9442
Phone number: 918-287-5425
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