Provider First Line Business Practice Location Address:
5002 SW LEE BLVD
Provider Second Line Business Practice Location Address:
CHRISTIAN FAMILY COUNSELING CENTER
Provider Business Practice Location Address City Name:
LAWTON
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73505-8320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-531-4512
Provider Business Practice Location Address Fax Number:
580-531-4519
Provider Enumeration Date:
08/15/2006