Provider First Line Business Practice Location Address:
17599 S HIGHWAY 88
Provider Second Line Business Practice Location Address:
STABILIZATION CENTER
Provider Business Practice Location Address City Name:
CLAREMORE
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74018-0801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-273-1841
Provider Business Practice Location Address Fax Number:
918-273-1843
Provider Enumeration Date:
10/08/2009