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1902106768
JAKE WESLEY LANDRETH
OWASSO, OK
NPI
1902106768
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
111N00000X Chiropractor
(Licence: OK 4002)
Enumeration Date
2010-10-27
Last Update Date
2010-10-27
Business Address
-- JAKE WESLEY LANDRETH dc
12707 E 86TH ST N
OWASSO, OK 74055-2506
Phone number: 918-272-7432
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Mailing Address
-- JAKE WESLEY LANDRETH dc
12707 E 86TH ST N
OWASSO, OK 74055-2506
Phone number: 918-272-7432
Copy
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