Individual
JIMMY RAY VANBUSKIRK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6717 NW 29TH ST, BETHANY, OK 73008-4729
(404) 531-8035
Mailing address
6717 NW 29TH ST, BETHANY, OK 73008-4729
(404) 531-8035
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/18/2024
Last updated
10/18/2024
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