Individual
JASON GERHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RSS
Contact information
Practice address
620 W GRAND AVE, PONCA CITY, OK 74601-5123
(580) 762-1462
(581) 765-7299
Mailing address
620 W GRAND AVE, PONCA CITY, OK 74601-5123
(580) 762-1462
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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