Individual
STASHA BLOUNT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
17287 W 32ND ST S, SAND SPRINGS, OK 74063-4774
(918) 289-6765
Mailing address
615 E LATIMER PL, TULSA, OK 74106-4833
(979) 559-1471
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1188010
TX
Other
Enumeration date
04/14/2021
Last updated
04/14/2021
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