Johnny White JR.

NPI #1366217929 in Owasso, Oklahoma

Provider Information

NPI Number: 1366217929
Entity Type: Individual
Name: Johnny White JR.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Enumeration Date: Nov 22, 2023
Last Updated: Nov 22, 2023

Practice Location

Address: 8311 N 99TH EAST AVE
City: Owasso
State: Oklahoma
ZIP Code: 74055-2359
Phone: (405) 240-0378

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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