Individual
MR. JERRY DURHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED., OTRL
Contact information
Practice address
2401 E HIGHLAND ST, SHAWNEE, OK 74801-6594
(405) 395-9117
Mailing address
2401 E HIGHLAND ST, SHAWNEE, OK 74801-6594
(405) 395-9117
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
158
OK
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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