JACK ALLEN LAFOUNTAIN

PARKER, AZ
NPI1710239181
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy163W00000X Registered Nurse
(Licence: OK  00580)
Enumeration Date2012-10-10
Last Update Date2012-10-10
Business Address
-- JACK ALLEN LAFOUNTAIN RN
12033 AGENCY RD
PARKER, AZ 85344-7718
Phone number: 580-451-0202
Mailing Address
-- JACK ALLEN LAFOUNTAIN RN
PO BOX 492
TIPTON, OK 73570-0492
Phone number: 580-451-0202
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