Individual
JEANETTE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19302 E ADMIRAL PL STE B, CATOOSA, OK 74015-3207
(918) 340-5505
Mailing address
23855 S HIGHWAY 66 TRLR 126, CLAREMORE, OK 74019
(918) 344-2247
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/09/2022
Last updated
02/09/2022
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