Individual
EDWARD EUGENE HOUSE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
905 FULLER AVE # C, POCOLA, OK 74902-2212
(479) 719-5915
Mailing address
905 FULLER AVE # C, POCOLA, OK 74902-2212
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA3784
AR
Other
Enumeration date
02/05/2025
Last updated
02/05/2025
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