Individual
JAY SHOEMATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1813 NW 32ND ST, LAWTON, OK 73505-3870
(580) 514-0766
Mailing address
1813 NW 32ND ST, LAWTON, OK 73505-3870
(580) 514-0766
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
04/06/2015
Last updated
04/06/2015
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