Individual
JENNIFER D SWEATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
112 EVANS AVE, MANNFORD, OK 74044
(918) 865-7020
(918) 865-7039
Mailing address
PO BOX 361, MANNFORD, OK 74044-0361
(918) 865-7020
(918) 865-7039
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3075
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3075
OKLAHOLMA MEDICAL BOARD PTA LICENSE
OK
Enumeration date
02/15/2021
Last updated
02/15/2021
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