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NPI Provider: 1699772806
Contact Name: Justice Lee Jack
Position: Owner
Phone: (405) 238-7391
Jack Justice Information:
Jack Justice organization have npi 1699772806, taxonomy code is 333600000X with license number is 22-3755 in . This Business address located in 110 Burr Ave, Pauls Valley, OK 73075 Oklahoma. Get directions of Jack Justice.
Practice Location
Address: 110 Burr Ave, Pauls Valley, OK 73075
Phone: (405) 238-7391
Business Location
Address: 110 Burr Ave, Pauls Valley, OK 73075
Phone: (405) 238-7391
Fax: (405) 238-1162
Taxonomy
Taxonomy Code: 333600000X
License Number: 22-3755
License Number of State: OK
Primary Taxonomy Switch: X
Enumeration Date: 7/1/2005
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