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Individual

JESSICA SARA STREU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
A.T.C.

Contact information

Practice address
2299 OLD BACONE RD, MUSKOGEE, OK 74403-1568
(918) 685-0809
Mailing address
2299 OLD BACONE RD, BACONE COLLEGE ATHLETICS, MUSKOGEE, OK 74403-1568
(918) 685-0809

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
505
OK

Other

Enumeration date
05/07/2008
Last updated
05/07/2008
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