Individual provider · Type 1 NPI
Dezjuan Vonte Jackson
Prosthetic/Orthotic Supplier · Oklahoma City, OK
Practice location
10461 N May Ave
Oklahoma City, OK 73120-2610
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | None listed |
| Prosthetic/Orthotic Supplier Primary | 335E00000X | 314007 (OK) |
Prosthetic/Orthotic Supplier: An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
Other prosthetic/orthotic supplier providers in Oklahoma City
About NPI 1679073183
Dezjuan Vonte Jackson's National Provider Identifier is 1679073183, issued on Feb 20, 2018. The primary taxonomy on file is Prosthetic/Orthotic Supplier (335E00000X), and the practice location is in Oklahoma City, OK. The record was last updated on Feb 20, 2018.