Individual
LIANE JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 LAURIE TATUM ROAD, ADULT CARE CLINIC 2, LAWTON, OK 73507
(580) 354-5000
Mailing address
1515 LAURIE TATUM ROAD, ADULT CARE CLINIC 2, LAWTON, OK 73507
(580) 354-5000
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
645341
TX
Other
Enumeration date
12/29/2017
Last updated
12/29/2017
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