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Individual

JAKE ANDREW STOPP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
513 TALLEY ST, TAHLEQUAH, OK 74464-6335
(918) 457-8495
Mailing address
1011 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-4733
(918) 457-8495

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Enumeration date
06/04/2021
Last updated
06/04/2021
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