Individual
JESSICA MARIE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
701 S MAIN ST, BROKEN ARROW, OK 74012-5528
(918) 259-5700
Mailing address
701 S MAIN ST, BROKEN ARROW, OK 74012-5528
(918) 259-5700
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1817
OK
Other
Enumeration date
07/01/2022
Last updated
07/01/2022
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