SHANA NETHERLAIN DAVIS

TAHLEQUAH, OK
NPI1861768384
Entity TypeOrganization
Authorized ContactSHANA NETHERLAIN DAVIS
Bhrs
918-864-1013
Organization Subpart ?No
Primary Taxonomy251S00000X 
Enumeration Date2012-03-29
Last Update Date2012-03-29
Business Address
SHANA NETHERLAIN DAVIS
1624 CLAYTON DR
TAHLEQUAH, OK 74464-8004
Phone number: 918-864-1013
Mailing Address
SHANA NETHERLAIN DAVIS
1624 CLAYTON DR
TAHLEQUAH, OK 74464-8004
Phone number: 918-864-1013