CASEY LAYNE WISE

BROKEN ARROW, OK
NPI1972028132
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2017-08-09
Last Update Date2017-08-09
Business Address
CASEY LAYNE WISE
1044 N NARCISSUS AVE
BROKEN ARROW, OK 74012-1468
Phone number: 918-505-8209
Mailing Address
CASEY LAYNE WISE
1044 N NARCISSUS AVE
BROKEN ARROW, OK 74012-1468
Phone number:
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