Individual
JACKSON OGBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5195 MAGNOLIA DR, JOPLIN, MO 64801-6406
(417) 684-7415
Mailing address
5195 MAGNOLIA DR, JOPLIN, MO 64801-6406
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
2020023671
MO
Other
Enumeration date
06/18/2024
Last updated
06/18/2024
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