Individual
JACLYN JO ANDREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4600 TAFT BLVD, WICHITA FALLS, TX 76308-4935
(940) 691-1710
(940) 691-2193
Mailing address
5238 SUNNYBROOK LN, WICHITA FALLS, TX 76310-3497
(940) 642-2193
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
111348
TX
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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