Luis Alfonse Jimenez Rincon

NPI 1760817977 - Community/Behavioral Health - 251S00000X

NPI Details
NPI 1760817977
Gender Male
Enumeration Date 09/06/2013
Last Updated 09/06/2013
Entity Type Individual
Active Over 3 years ago
Practice Location
3501 S 1ST ST
BROKEN ARROW OK, 74012-7916, US
Phone (918) 813-3826
Fax
Business Location
3501 S 1ST ST
BROKEN ARROW OK, 74012-7916, US
Phone (918) 813-3826
Fax
Toxanomy
Taxonomy Code 251S00000X
License State Oklahoma
License Number 171M00000X
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According to our database, Luis Alfonse Jimenez Rincon NPI is 1760817977, taxonomy code is 251S00000X and license number is 171M00000X, license state is located at Oklahoma. Luis Alfonse Jimenez Rincon physically located at 3501 S 1st St, Broken Arrow OK, 74012-7916. NPI Number Luis Alfonse Jimenez Rincon has the Individual type.

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1760817977 NPI number is provided on an as is basis without warranty of any kind. 1760817977 is maintained by the National Plan & Provider Enumeration System. The contents of Luis Alfonse Jimenez Rincon are for informational purposes only.