Individual
JAMIE MICHELE BURCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11129 SW 38TH CIR, MUSTANG, OK 73064-9269
(405) 920-0293
Mailing address
11129 SW 38TH CIR, MUSTANG, OK 73064-9269
(405) 920-0293
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024812983
—
OK
Enumeration date
03/06/2019
Last updated
03/06/2019
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