Provider First Line Business Practice Location Address:
815 E 6TH ST
Provider Second Line Business Practice Location Address:
CHICKASAW NATION HEALTH CLINIC
Provider Business Practice Location Address City Name:
TISHOMINGO
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73460-1800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-240-2720
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/22/2005