Individual
MR. JEREMY GLENN HORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6216 S LEWIS AVE, STE 180, TULSA, OK 74136-1044
(918) 960-7852
Mailing address
1513 W TRENTON ST, BROKEN ARROW, OK 74012-0479
(918) 237-2514
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/29/2012
Last updated
10/29/2012
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