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Individual

JARRELL JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7614 SW CHEROKEE AVE, LAWTON, OK 73505-6421
(580) 678-6902
Mailing address
7614 SW CHEROKEE AVE, LAWTON, OK 73505-6421
(580) 678-6902

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Enumeration date
01/28/2014
Last updated
01/28/2014
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