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1962811802
DYLAN VICTOR LESLIE
CANADIAN, OK
NPI
1962811802
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
324500000X Substance Abuse Rehabilitation Facility
Enumeration Date
2014-08-05
Last Update Date
2014-08-05
Business Address
DYLAN VICTOR LESLIE
69 ARROWHEAD LOOP
CANADIAN, OK 74425-5012
Phone number: 918-339-5800
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Mailing Address
DYLAN VICTOR LESLIE
69 ARROWHEAD LOOP
CANADIAN, OK 74425-5012
Phone number: 918-339-5800
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