Individual
JERA D BURTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
220 N MORELAND AVE, WATONGA, OK 73772-4038
(405) 822-6847
(580) 623-5776
Mailing address
220 N MORELAND AVE, WATONGA, OK 73772-4038
(405) 822-6847
(580) 623-5776
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
10/19/2018
Last updated
10/19/2018
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