Individual
MR. JAMES GLEN BRUNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 DOLLINS ST, WILBURTON, OK 74578-3204
(918) 448-5497
Mailing address
800 DOLLINS ST, WILBURTON, OK 74578-3204
(918) 448-5497
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
—
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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