Individual
THERESA D LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
4815 S HARVARD AVE STE 455, TULSA, OK 74135-3078
(918) 712-7805
(918) 712-7813
Mailing address
7419 E 131ST ST S, BIXBY, OK 74008-3113
(918) 369-3179
(918) 369-3179
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3890
OK
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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