Most Relevant Information
Provider Data
| NPI Number: | 1003456310 |
| Provider Name: | JACK BEAMS |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/14/2020 |
| Last Updated: | 01/14/2020 |
Provider Practice Location
7401 NE 23RD ST
OKLAHOMA CITY
OK
731411420
Practice Location Phone/Fax
| Phone: | 4057788007 |
| Fax: |
Provider Mailing Location
7401 NE 23RD ST
OKLAHOMA CITY
OK
731411420
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |