Individual
CHRISTOPHER JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, SLP
Contact information
Practice address
1211 N SHARTEL AVE, SUITE 200, OKLAHOMA CITY, OK 73103-2400
(405) 355-3239
Mailing address
1211 N SHARTEL AVE, SUITE 200, OKLAHOMA CITY, OK 73103-2400
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4046
OK
Other
Enumeration date
04/08/2013
Last updated
04/08/2013
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