Individual
JARED DAVIS SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2303 W 113TH CT S, JENKS, OK 74037-1729
(580) 747-8860
Mailing address
2303 W 113TH CT S, JENKS, OK 74037-1729
(580) 747-8860
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
805
OK
Other
Enumeration date
01/17/2023
Last updated
01/17/2023
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