Individual
LAZARUS CLASSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3209 S BROADWAY STE 105, EDMOND, OK 73013-4063
(405) 546-4797
Mailing address
PO BOX 746, HARRAH, OK 73045-0746
(405) 454-0010
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3149
OK
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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