Individual
JERSON PENAFLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
905 S MAIN ST, SHATTUCK, OK 73858-9205
(580) 938-5518
(580) 938-5335
Mailing address
1118 S SUMMER ST, SHATTUCK, OK 73858-9424
(580) 216-5036
Taxonomy
Speciality
Code
Description
License number
State
246QM0706X
Medical Technologist
Primary
—
—
Other
Enumeration date
01/05/2026
Last updated
01/05/2026
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