Individual
JARED W JEFFERIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 N 6TH ST, PONCA CITY, OK 74601-2827
(580) 762-7561
(580) 762-2576
Mailing address
3536 SPRINGWOOD ST, APT 507, PONCA CITY, OK 74604-1629
(580) 789-1860
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/12/2012
Last updated
04/12/2012
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