Individual
JACE CLINKENBEARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1201 HERITAGE CIR, PAWNEE, OK 74058-3744
(918) 762-2517
Mailing address
116 LEANING TREE RD, FORT GIBSON, OK 74434-7611
(918) 685-0935
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6644
OK
Other
Enumeration date
12/11/2024
Last updated
12/16/2024
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