Individual
LISA JO LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2221 W DETROIT ST, BROKEN ARROW, OK 74012-3628
(918) 615-6492
Mailing address
15022 S JUSTIN AVE, GLENPOOL, OK 74033-4420
(918) 640-7828
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2475
OK
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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