Individual
JAZMINE S KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23 E ROSS AVE, SAPULPA, OK 74066-6423
(918) 227-2016
Mailing address
303 N ADAMS ST, SAPULPA, OK 74066-3658
(318) 517-0308
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/19/2022
Last updated
10/01/2022
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