Individual
JACLYN DEANN ROUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
410 NORTH M STREET, HUGO, OK 74743
(580) 326-7561
(580) 326-7564
Mailing address
410 NORTH M STREET, HUGO, OK 74743
(580) 326-7561
(580) 326-7564
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2855
OK
Other
Enumeration date
07/31/2015
Last updated
02/12/2019
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