LEISA BLOSSOM

WESTVILLE, OK
NPI1922456375
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy247200000X 
Enumeration Date2016-05-26
Last Update Date2016-05-26
Business Address
-- LEISA BLOSSOM
500 WEST CHINCAPIN
WESTVILLE, OK 74965
Phone number: 918-723-3181
Mailing Address
-- LEISA BLOSSOM
PO BOX 410
WESTVILLE, OK 74965-0410
Phone number: 918-723-3181
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