MICKEY DEWAYNE JACK

ATOKA, OK
NPI1861768715
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2012-03-26
Last Update Date2012-03-26
Business Address
Mr. MICKEY DEWAYNE JACK BHRS
303 E COURT ST
ATOKA, OK 74525-2047
Phone number: 580-889-3399
Mailing Address
Mr. MICKEY DEWAYNE JACK BHRS
126 W 4TH ST
ATOKA, OK 74525-2501
Phone number: 580-230-1613
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