Individual
JEREMY DELL SELLERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
1104 FRANCES ST, BURKBURNETT, TX 76354-3222
(940) 730-5602
Mailing address
1104 FRANCES ST, BURKBURNETT, TX 76354-3222
(940) 730-5602
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
198497
TX
Other
Enumeration date
06/04/2019
Last updated
06/04/2019
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