Jerry Wade

NPI #1396471231 in Ada, Oklahoma

Provider Information

NPI Number: 1396471231
Entity Type: Individual
Name: Jerry Wade
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: Jul 25, 2022
Last Updated: Jul 25, 2022

Practice Location

Address: 301 W 4TH ST
City: Ada
State: Oklahoma
ZIP Code: 74820-3411
Phone: (580) 257-2444

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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