Individual
MOLLY ELLEN MANUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1742 S 4TH ST, CHICKASHA, OK 73018-5901
(405) 825-3617
(405) 825-3618
Mailing address
2234 W HOUSTON ST STE B, BROKEN ARROW, OK 74012-3519
(918) 259-1888
(918) 251-3725
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3665
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200533540A
—
OK
Enumeration date
06/15/2006
Last updated
10/06/2016
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