Individual
JENNY SMART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1505 SW BISHOP RD, LAWTON, OK 73501-7902
(580) 678-0013
Mailing address
1505 SW BISHOP RD, LAWTON, OK 73501-7902
(580) 678-0013
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
01/06/2014
Last updated
01/06/2014
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