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1811214083
MICAH GRANT LANE
DURANT, OK
NPI
1811214083
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2010-04-28
Last Update Date
2010-04-28
Business Address
Mr. MICAH GRANT LANE B.A.
212 W EVERGREEN ST
DURANT, OK 74701-4710
Phone number: 580-931-9901
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Mailing Address
Mr. MICAH GRANT LANE B.A.
212 W EVERGREEN ST
DURANT, OK 74701-4710
Phone number: 580-931-9901
Copy
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