Individual
CALVIN JACOB ELMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14828 SERENITA AVE., OKLAHOMA CITY, OK 73134-7313
(405) 838-1994
Mailing address
217 PONT MIRABEAU CIR, EDMOND, OK 73034-9388
(405) 240-2481
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/02/2021
Last updated
08/02/2021
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