Individual
MR. JEREMY ALAN FRUTCHEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5023 S 36TH WEST AVE, TULSA, OK 74107-7403
(405) 269-2821
Mailing address
5023 S 36TH WEST AVE, TULSA, OK 74107-7403
(405) 269-2821
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/08/2010
Last updated
10/08/2010
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