Individual
MR. DAKOTA SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
13801 N WESTERN AVE STE B, EDMOND, OK 73013-1798
(405) 946-7300
Mailing address
924 PATCO SPUR AVE, YUKON, OK 73099-7166
(405) 625-3768
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2803
OK
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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