Individual
TALIA FORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3029 W MAIN ST, JENKS, OK 74037-3465
(918) 701-2300
Mailing address
13680 KENOSHA AVE, GLENPOOL, OK 74033-3829
(918) 639-9013
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3558
OK
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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