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1538838040
LARRY DWAYNE MULLIN
VINITA, OK
NPI
1538838040
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2021-09-08
Last Update Date
2021-09-14
Business Address
LARRY DWAYNE MULLIN
405 E EXCELSIOR AVE
VINITA, OK 74301-4226
Phone number: 918-325-7005
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Mailing Address
LARRY DWAYNE MULLIN
PO BOX 712
AFTON, OK 74331-0712
Phone number:
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