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1952404238
JAMIE SHANE MASSENGILL
EDMOND, OK
NPI
1952404238
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: OK 1320)
Enumeration Date
2006-09-05
Last Update Date
2020-02-09
Business Address
Mr. JAMIE SHANE MASSENGILL PA-C
7555 WINTERWOOD DR
EDMOND, OK 73025-1861
Phone number: 405-990-5967
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Mailing Address
Mr. JAMIE SHANE MASSENGILL PA-C
7555 WINTERWOOD DR
EDMOND, OK 73025-1861
Phone number: 405-990-5967
Copy
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