Individual
KIM ANNE HASLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3000 SOUTH ELM PLACE, BROKEN ARROW, OK 74012
(918) 451-5143
(918) 451-5287
Mailing address
11664 SOUTH 252 EAST AVE, BROKEN ARROW, OK 74014
(918) 486-5821
(918) 451-5287
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TA 591
OK
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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