Individual
JASON SEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
351 N AIR DEPOT BLVD, MIDWEST CITY, OK 73110-1700
(405) 732-1766
Mailing address
777 N AIR DEPOT BLVD, #3308, MIDWEST CITY, OK 73110-3700
(405) 717-0506
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102
LICENSE#
OK
Enumeration date
08/30/2006
Last updated
07/08/2007
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