Individual
MR. MARSHALL LEO DEJEAR II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 CREEK DR, OKMULGEE, OK 74447-6550
(918) 752-4341
(918) 756-2233
Mailing address
601 CREEK DR, OKMULGEE, OK 74447-6550
(918) 752-4341
(918) 756-2233
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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