Individual
LESLIE ALFRED BOTCHWEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5577 S LEWIS AVE, TULSA, OK 74105-7136
(918) 749-0003
(918) 749-0210
Mailing address
5577 S LEWIS AVE, TULSA, OK 74105-7136
(918) 749-0003
(918) 749-0210
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4005
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4005
MEDICAL LICENSE
OK
Enumeration date
05/14/2007
Last updated
07/08/2007
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