Individual
JENNIE LEIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6500 N PORTLAND AVE, OKLAHOMA CITY, OK 73116-2035
(405) 879-9947
Mailing address
1001 NW 9TH ST, MOORE, OK 73160-1811
(405) 317-3317
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1414
OK
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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