Individual
TIFFANY LYNN BRANTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6205 NW FERRIS AVE, LAWTON, OK 73505-5703
(580) 353-0334
Mailing address
6205 NW FERRIS AVE, LAWTON, OK 73505-5703
(580) 353-0334
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2963
OK
Other
Enumeration date
02/05/2021
Last updated
02/05/2021
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