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1497039135
CHARLES LEE TUCKER
SPENCER, OK
NPI
1497039135
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK 1225)
Enumeration Date
2011-09-29
Last Update Date
2011-09-29
Business Address
Mr. CHARLES LEE TUCKER LADC
12925 NE 59TH ST
SPENCER, OK 73084-8605
Phone number: 405-464-2922
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Mailing Address
Mr. CHARLES LEE TUCKER LADC
12925 NE 59TH ST
SPENCER, OK 73084-8605
Phone number: 405-464-2922
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