Individual
JESSE CRAIGHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
747 HIGHWAY 59 # 4, WESTVILLE, OK 74965-1508
(918) 723-3757
Mailing address
747 HIGHWAY 59 # 4, WESTVILLE, OK 74965-1508
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
200534020A
OK
Other
Enumeration date
03/16/2016
Last updated
03/16/2016
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