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1922456375
LEISA BLOSSOM
WESTVILLE, OK
NPI
1922456375
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
247200000X Technician, Other
Enumeration Date
2016-05-26
Last Update Date
2016-05-26
Business Address
-- LEISA BLOSSOM
500 WEST CHINCAPIN
WESTVILLE, OK 74965
Phone number: 918-723-3181
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Mailing Address
-- LEISA BLOSSOM
PO BOX 410
WESTVILLE, OK 74965-0410
Phone number: 918-723-3181
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