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1073693099
JACKIE MCDANIEL
ADA, OK
NPI
1073693099
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: OK 1265)
Enumeration Date
2006-10-16
Last Update Date
2007-07-23
Business Address
-- JACKIE MCDANIEL
1001 N COUNTRY CLUB RD
ADA, OK 74820-2847
Phone number: 580-421-4570
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Mailing Address
-- JACKIE MCDANIEL
1001 N COUNTRY CLUB RD
ADA, OK 74820-2847
Phone number: 580-421-4570
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