Individual
LATASHA ROSHAWN SUTTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
1112 W ELMIRA ST, BROKEN ARROW, OK 74012-0871
(918) 872-1825
Mailing address
1112 W ELMIRA ST, BROKEN ARROW, OK 74012-0871
(918) 872-1825
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1664
OK
Other
Enumeration date
05/10/2013
Last updated
05/10/2013
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