Individual
MRS. SUSAN CHRISTINE MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2169 S 77TH EAST AVE, TULSA, OK 74129-2417
(918) 798-5888
(918) 622-6169
Mailing address
2169 S 77TH EAST AVE, TULSA, OK 74129-2417
(918) 798-5888
(918) 622-6169
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3651
OK
Other
Enumeration date
10/12/2007
Last updated
10/12/2007
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