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Individual

DALLAS ESSARY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1801 W LOCUST ST, STILWELL, OK 74960-3259
(918) 696-7276
Mailing address
1801 W LOCUST ST, STILWELL, OK 74960-3259
(918) 696-7276

Taxonomy

Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100688200A
OK
Enumeration date
03/09/2016
Last updated
03/09/2016
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