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1487053898
JAMES ELLIS BOHANNON
LAWTON, OK
NPI
1487053898
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2014-08-21
Last Update Date
2014-08-21
Business Address
-- JAMES ELLIS BOHANNON M.S.B.S.
601 SW B AVE
LAWTON, OK 73501-3907
Phone number: 580-214-0244
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Mailing Address
-- JAMES ELLIS BOHANNON M.S.B.S.
6121 SW PARK PL
LAWTON, OK 73505-7731
Phone number: 619-341-2413
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