Individual
CASEY R LYLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
625 N MONTE VISTA ST, ADA, OK 74820-4613
(580) 436-5111
(580) 436-1159
Mailing address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3286
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/05/2022
Last updated
08/05/2022
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