Individual
MARY KATHLEEN STALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
744 W 9TH ST, REHAB MEDICINE DEPT (H205), TULSA, OK 74127-9020
(918) 599-5190
(918) 599-5818
Mailing address
5117 E 25TH ST, TULSA, OK 74114-3721
(918) 742-5187
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT1080
OK
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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