Dezjuan Vonte Jackson
NPI #1679073183 in Oklahoma City, Oklahoma
Provider Information
- NPI Number
- 1679073183
- Entity Type
- Individual
- Name
- Dezjuan Vonte Jackson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Prosthetic/Orthotic Supplier
- Enumeration Date
- Feb 20, 2018
- Last Updated
- Feb 20, 2018
Practice Location
- Address
- 10461 N MAY AVE
- City
- Oklahoma City
- State
- Oklahoma
- ZIP Code
- 73120-2610
- Phone
- (405) 543-6314
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
| Prosthetic/Orthotic Supplier |
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