Individual
GINA DILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
721 NW 6TH ST, OKLAHOMA CITY, OK 73102-1205
(405) 938-8332
Mailing address
721 NW 6TH ST, OKLAHOMA CITY, OK 73102-1205
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5103
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063823771
VALIR PACE
—
Enumeration date
09/28/2018
Last updated
09/28/2018
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