Individual
JESSICA LANE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 KERR AVE, POTEAU, OK 74953-5270
(539) 316-4616
Mailing address
109 KERR AVE, POTEAU, OK 74953-5270
(539) 316-4616
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/30/2024
Last updated
10/30/2024
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