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1962145714
MICHAEL ANTHONY DITMORE
DUNCAN, OK
NPI
1962145714
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2022-04-19
Last Update Date
2022-04-19
Business Address
MICHAEL ANTHONY DITMORE
1016 W MAPLE AVE
DUNCAN, OK 73533-4761
Phone number: 580-606-6719
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Mailing Address
MICHAEL ANTHONY DITMORE
164484 5 MILE RD
MARLOW, OK 73055-5282
Phone number: 580-721-1221
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