Individual
JESSE COLE CHILDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8612 NW 125TH ST, OKLAHOMA CITY, OK 73142-2268
(405) 361-9029
Mailing address
PO BOX 721703, OKLAHOMA CITY, OK 73172-1703
(405) 361-9029
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/29/2024
Last updated
08/29/2024
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