LILY GRACE SOUTHERN

TAHLEQUAH, OK
NPI1447854260
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2020-11-23
Last Update Date2020-11-23
Business Address
LILY GRACE SOUTHERN
16414 W 760 RD
TAHLEQUAH, OK 74464-1675
Phone number: 918-708-9009
Mailing Address
LILY GRACE SOUTHERN
67612 S 260 RD
WAGONER, OK 74467-6250
Phone number: 918-688-8801