Individual
JACK ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1528 NW 35TH ST, OKLAHOMA CITY, OK 73118-3214
(405) 543-3746
Mailing address
1528 NW 35TH ST, OKLAHOMA CITY, OK 73118-3214
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/12/2025
Last updated
07/12/2025
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