Individual
JACOB BAUCHOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10390 E 21ST ST, TULSA, OK 74129-1606
(918) 665-7077
(918) 665-7099
Mailing address
10390 E 21ST ST, TULSA, OK 74129-1606
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3607
TN
Other
Enumeration date
09/26/2022
Last updated
11/07/2023
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