Individual
JACKIE J MONK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
608 HIGHWAY 271 N, ANTLERS, OK 74523-2055
(580) 298-5062
(580) 298-5072
Mailing address
RR 1 BOX 181, GARVIN, OK 74736-9731
(580) 212-9055
(580) 298-5072
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/10/2009
Last updated
11/10/2009
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