Individual
JOHN MICHAEL BREST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.O., C.PED
Contact information
Practice address
4011 FRONTIER RD, SAPULPA, OK 74066-9383
(918) 227-2704
Mailing address
4011 FRONTIER RD, SAPULPA, OK 74066-9383
(918) 227-2704
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
LO 18
OK
Other
Enumeration date
09/08/2010
Last updated
09/08/2010
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