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1952087744
DEZERY NICOLE MUCKER
LAWTON, OK
NPI
1952087744
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2023-06-26
Last Update Date
2023-06-26
Business Address
DEZERY NICOLE MUCKER
1503 W GORE BLVD.
LAWTON, OK 73505
Phone number: 580-289-0246
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Mailing Address
DEZERY NICOLE MUCKER
6718 SW DRIFTWOOD DR.
LAWTON, OK 73505
Phone number: 580-917-7398
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