Bontrager, Jacqueline
Bontrager, Jacqueline is an sole proprietor health care provider with primary practice located at 3015 E Skelly Dr Suite 103, Tulsa OK 74105-6317. She recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as her primary health care specialty. Bontrager, Jacqueline can be contacted via phone (918) 712-0859.Contact Information
Primary practice address
3015 E Skelly Dr Suite 103
Tulsa OK 74105-6317
Phone: (918) 712-0859
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Community/Behavioral Health | 251S00000X |
Profile Details
| NPI number | 1245655448 |
|---|---|
| LBN Legal business name | Bontrager, Jacqueline |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 25th, 2014 |
| Last updated | Feb 25th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245655448 | NPPES |
| Oklahoma | MEDICAID | 100746170G |
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