Organization
PEDORTHIC FOOTCARE OF OKLAHOMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN JAEGER CPED, LPED (CERTIFIED & LICENSED PEDORTHIST)
(405) 924-7306
Entity
Organization
Contact information
Practice address
5100 N BROOKLINE AVE STE 330, OKLAHOMA CITY, OK 73112-3603
(405) 924-7306
(405) 600-7287
Mailing address
5100 N BROOKLINE AVE STE 330, OKLAHOMA CITY, OK 73112-3603
(405) 924-7306
(405) 600-7287
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
84
OK
Other
Enumeration date
03/12/2012
Last updated
04/12/2012
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