Individual
MRS. BRANDI CAROL JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 15TH AVE NW, ARDMORE, OK 73401-2047
(580) 277-0890
Mailing address
55 15TH AVE NW, ARDMORE, OK 73401-2047
(580) 277-0890
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/03/2013
Last updated
01/03/2013
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