Individual
MR. JOHN MARK HEUSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC, CSCS
Contact information
Practice address
6201 N SANTA FE AVE, OKLAHOMA CITY, OK 73118-7538
(405) 272-5478
Mailing address
8320 NW 111TH TER, OKLAHOMA CITY, OK 73162-2100
(405) 818-7910
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AT-82
OK
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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