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1992426993
PHOENIX M ROUSSEAU
LAWTON, OK
NPI
1992426993
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2022-09-07
Last Update Date
2022-09-07
Business Address
PHOENIX M ROUSSEAU
1114 SW A AVE
LAWTON, OK 73501-3819
Phone number: 580-357-8114
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Mailing Address
PHOENIX M ROUSSEAU
1114 SW A AVE
LAWTON, OK 73501-3819
Phone number: 580-357-8114
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