MICHAEL JACK

JOPLIN, MO
NPI1629023288
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: MO  083875)
Enumeration Date2006-05-23
Last Update Date2007-10-23
Business Address
-- MICHAEL JACK CRNA
1102 W 32ND ST
JOPLIN, MO 64804
Phone number: 417-347-1078
Mailing Address
-- MICHAEL JACK CRNA
PO BOX 3810
JOPLIN, MO 64803-3810
Phone number: 417-347-1078
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