Individual
BILLY JACK GREGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23899 STATE HIGHWAY 74, PURCELL, OK 73080-6964
(405) 779-1525
Mailing address
7321 EDENBOROUGH DR, OKLAHOMA CITY, OK 73132-5617
(405) 779-1525
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/06/2021
Last updated
10/06/2021
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