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1972963726
DUSTIN TATHAM
SALLISAW, OK
NPI
1972963726
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2016-03-07
Last Update Date
2016-03-07
Business Address
-- DUSTIN TATHAM
701 S J T STITES ST
SALLISAW, OK 74955-9304
Phone number: 918-775-5544
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Mailing Address
-- DUSTIN TATHAM
701 S J T STITES ST
SALLISAW, OK 74955-9304
Phone number: 918-775-5544
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