Provider First Line Business Practice Location Address:
310 HIGH SCHOOL ST
Provider Second Line Business Practice Location Address:
TUPELO HIGH SCHOOL
Provider Business Practice Location Address City Name:
TUPELO
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74572
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-845-2381
Provider Business Practice Location Address Fax Number:
580-845-2565
Provider Enumeration Date:
11/02/2006