Individual
THERON JOSEPH BLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
220 S ELM ST, JENKS, OK 74037
(918) 403-7144
(918) 856-5561
Mailing address
220 S ELM ST, JENKS, OK 74037-3701
(918) 403-7144
(918) 856-5561
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4618
OK
207QS0010X
Sports Medicine (Family Medicine) Physician
4618
OK
Other
Enumeration date
06/20/2007
Last updated
05/22/2018
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