Individual
JUSTIN SHAWVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
301 W I 240 SERVICE RD, OKLAHOMA CITY, OK 73139-7701
(405) 635-3837
Mailing address
301 W I 240 SERVICE RD, OKLAHOMA CITY, OK 73139-7701
(405) 635-3837
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
56088
OK
Other
Enumeration date
10/22/2015
Last updated
10/22/2015
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