Individual
JACK RYAN NORGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1921 STONECIPHER DR, ADA, OK 74820-3439
(580) 436-3980
Mailing address
1035 E WILCOX AVE, WHITE CLOUD, MI 49349-8794
(231) 689-5943
(231) 689-1590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7797
OK
Other
Enumeration date
04/01/2020
Last updated
08/06/2024
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