Individual
JONATHAN GREENWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1414 N KENNEDY AVE, SHAWNEE, OK 74801-4700
(405) 275-3391
Mailing address
1414 N KENNEDY AVE, SHAWNEE, OK 74801-4700
(405) 275-3391
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0269310306
OK
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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