CHARLES LEE TUCKER

SPENCER, OK
NPI1497039135
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK  1225)
Enumeration Date2011-09-29
Last Update Date2011-09-29
Business Address
Mr. CHARLES LEE TUCKER LADC
12925 NE 59TH ST
SPENCER, OK 73084-8605
Phone number: 405-464-2922
Mailing Address
Mr. CHARLES LEE TUCKER LADC
12925 NE 59TH ST
SPENCER, OK 73084-8605
Phone number: 405-464-2922