Individual
JASON SCOT EDGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
820 N HICKORY AVE, BROKEN ARROW, OK 74012-1645
(580) 475-2974
Mailing address
820 N HICKORY AVE, BROKEN ARROW, OK 74012-1645
(580) 475-2974
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/10/2013
Last updated
02/10/2013
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