Provider First Line Business Practice Location Address:
100 W COOWEESCOOWEE
Provider Second Line Business Practice Location Address:
CO OOLOGAH TALALA EMS
Provider Business Practice Location Address City Name:
CLAREMORE
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74017-3609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-443-2350
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/01/2006