Individual
JILL LOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
372 URY RD, CADDO, OK 74729-4105
(580) 230-8442
Mailing address
372 URY RD, CADDO, OK 74729-4105
(580) 230-8442
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0051481
OK
Other
Enumeration date
01/06/2014
Last updated
01/06/2014
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