Individual
BREANNA ROCHELLE EDENBOROUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4651 N HARRISON ST, SHAWNEE, OK 74804-1440
(405) 214-1524
(405) 395-5653
Mailing address
4651 N HARRISON ST, SHAWNEE, OK 74804-1440
(405) 214-1524
(405) 395-5653
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5327
OK
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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