Individual
MR. ROGER DALE WANTLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
1901 PARKWAY DRIVE, ELRENO, OK 73036
(405) 262-2608
(405) 262-2558
Mailing address
4350 WILL ROGERS PKWY STE 600, OKLAHOMA CITY, OK 73108-1808
(405) 948-2813
(405) 948-2807
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1850
OK
Other
Enumeration date
12/31/2015
Last updated
12/31/2015
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