Individual
MR. RICKY NEIL RISENHOOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
23 PLAZA SOUTH ST, TAHLEQUAH, OK 74464-4750
(918) 431-1919
(918) 431-1636
Mailing address
23 PLAZA SOUTH, TAHLEQUAH, OK 74464
(918) 431-1919
(918) 431-1636
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1606
OK
Other
Enumeration date
06/29/2006
Last updated
02/08/2008
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