Individual
JEFFERIES BLAKE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10700 S CHOCTAW RD, NEWALLA, OK 74857-7962
(405) 742-7713
Mailing address
7701 S ANDERSON RD, OKLAHOMA CITY, OK 73150-6708
(405) 742-7713
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/07/2020
Last updated
06/08/2020
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