Individual
JASON MCCLUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1505 E MAIN ST STE B, STIGLER, OK 74462-2804
(918) 967-4000
Mailing address
1505 E MAIN ST STE B, STIGLER, OK 74462-2804
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200047100A
—
OK
Enumeration date
11/15/2006
Last updated
02/27/2009
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