Individual
JADE MARIE SUTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
407 W SOUTH AVE, PONCA CITY, OK 74601-6133
(580) 308-5515
(580) 215-5765
Mailing address
407 W SOUTH AVE, PONCA CITY, OK 74601-6133
(580) 308-5515
(580) 215-5765
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
Other
Enumeration date
10/27/2021
Last updated
12/09/2021
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