Individual
JACE A WOLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
11500 N PORTLAND AVE, OKLAHOMA CITY, OK 73120-4625
(405) 548-4300
Mailing address
11500 N PORTLAND AVE, OKLAHOMA CITY, OK 73120-4625
(405) 548-4300
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
281
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100656370A
—
OK
05
—
100656370B
—
OK
Enumeration date
11/14/2006
Last updated
10/23/2017
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