Individual
JACOB DUPREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
410 W LILLIE BLVD, MADILL, OK 73446-1270
(580) 872-4277
(580) 872-4261
Mailing address
1405 4TH AVE NW # 296, ARDMORE, OK 73401-2708
(580) 226-5566
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2840
OK
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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