Individual
CHARLEE NUSSBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
14002 E 21ST ST STE 650, TULSA, OK 74134-1425
(405) 355-3239
Mailing address
20740 E 45TH ST S, BROKEN ARROW, OK 74014-8741
(918) 207-9233
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3453
OK
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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