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1508999558
JERRY WYATT
DURANT, OK
NPI
1508999558
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: OK 3456)
Enumeration Date
2007-03-13
Last Update Date
2008-08-21
Business Address
-- JERRY WYATT MBS
1925 W ELM ST
DURANT, OK 74701-3429
Phone number: 580-924-6363
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Mailing Address
-- JERRY WYATT MBS
1925 W ELM ST
DURANT, OK 74701-3429
Phone number: 580-924-6363
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