Individual
JENNY RAE KIZZIAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RSS
Contact information
Practice address
1500 N 6TH ST, PONCA CITY, OK 74601-2827
(580) 763-0931
Mailing address
1500 N 6TH ST, PONCA CITY, OK 74601-2827
(580) 763-0931
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/15/2018
Last updated
02/15/2018
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