Individual
MR. JEROME DARIO ALDO DINAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
500 N CLARENCE NASH BLVD, WATONGA, OK 73772-2845
(580) 623-7211
Mailing address
500 N CLARENCE NASH BLVD, WATONGA, OK 73772-2845
(580) 623-7211
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2008
OK
Other
Enumeration date
01/30/2011
Last updated
01/30/2011
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