Individual
JODIE SHAVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
6037 SE 88TH ST, OKLAHOMA CITY, OK 73135-6099
(405) 921-7745
Mailing address
6037 SE 88TH ST, OKLAHOMA CITY, OK 73135-6099
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/19/2025
Last updated
11/19/2025
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