Individual
JESSE CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
327 SW C AVE, LAWTON, OK 73501-4016
(580) 248-5436
Mailing address
327 SW C AVE, LAWTON, OK 73501-4016
(580) 248-5436
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0119371
OK
Other
Enumeration date
08/11/2016
Last updated
08/11/2016
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