Individual
MR. DAKOTA RAY LECLAIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2307 GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 273-5236
Mailing address
2307 GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 273-5236
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
200149
OK
Other
Enumeration date
03/08/2021
Last updated
03/08/2021
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