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Individual

RONALD DEAN LACEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
101 N UNION AVE, SHAWNEE, OK 74801-7067
(405) 878-1135
Mailing address
1010 N MONTE VISTA ST, ADA, OK 74820-7702

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
05/23/2007
Last updated
07/08/2007
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