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Individual

JACOB THOMAS DUVALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
900 N PORTER AVE STE 110, NORMAN, OK 73071-6426
(405) 424-7711
Mailing address
3160 ROCK CREEK TRL APT 1712, NORMAN, OK 73072-2536
(405) 210-0384

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
175T00000X
Peer Specialist

Other

Enumeration date
09/06/2021
Last updated
11/12/2024
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