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1861768384
SHANA NETHERLAIN DAVIS
TAHLEQUAH, OK
NPI
1861768384
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Entity Type
Organization
Authorized Contact
SHANA NETHERLAIN DAVIS
Bhrs
918-864-1013
Organization Subpart ?
No
Primary Taxonomy
251S00000X
Enumeration Date
2012-03-29
Last Update Date
2012-03-29
Business Address
SHANA NETHERLAIN DAVIS
1624 CLAYTON DR
TAHLEQUAH, OK 74464-8004
Phone number: 918-864-1013
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Mailing Address
SHANA NETHERLAIN DAVIS
1624 CLAYTON DR
TAHLEQUAH, OK 74464-8004
Phone number: 918-864-1013
Copy
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