Individual
JENNA LEE MUSGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
715 W MAIN ST STE S, JENKS, OK 74037-3553
(918) 299-9447
Mailing address
108 N TAYLOR AVE, WYNNEWOOD, OK 73098-4625
(405) 990-5309
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2124
OK
Other
Enumeration date
02/21/2012
Last updated
02/12/2013
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