Individual
DAVID DUANE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3005 N ROBINSON AVE, OKLAHOMA CITY, OK 73103-4124
(405) 412-8495
(405) 412-8495
Mailing address
3005 N ROBINSON AVE, OKLAHOMA CITY, OK 73103-4124
(405) 412-8495
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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