Individual
CHRYSANTHEMUM JADE EWERTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8017 NW 114TH ST, OKLAHOMA CITY, OK 73162-2002
(405) 209-0799
Mailing address
8017 NW 114TH ST, OKLAHOMA CITY, OK 73162-2002
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
10/06/2025
Last updated
10/06/2025
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