Individual
TY R MARIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 E CLARK BASS BLVD, MCALESTER, OK 74501-4209
(918) 426-1800
Mailing address
300 SPAULDING RD, HOLDENVILLE, OK 74848-9402
(405) 380-6609
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
12/19/2023
Last updated
12/19/2023
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