Individual
MRS. JESSICA LOIS HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
109 KERR AVE, POTEAU, OK 74953-5270
(918) 649-1100
Mailing address
23475 US HIGHWAY 270, HOWE, OK 74940-7228
(918) 658-5996
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2148
OK
Other
Enumeration date
08/30/2012
Last updated
08/30/2012
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