Individual
MISS JACY ELAINE MUNCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 S HARRILL AVE, WAGONER, OK 74467-5317
(918) 485-0242
Mailing address
32269 E 689 LOOP, WAGONER, OK 74467-8344
(918) 413-2731
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/29/2022
Last updated
12/29/2022
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