Provider First Line Business Practice Location Address:
12 & 12 INC. CENTER FOR ADDICTION TREATMENT
Provider Second Line Business Practice Location Address:
6333 E. SKELLY DRIVE
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-664-4224
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2006