Individual
HALEY EKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1414 S DENVER AVE, TULSA, OK 74119-3423
(918) 712-7805
Mailing address
212 W CENTRAL AVE, MIAMI, OK 74354-6803
(785) 408-2390
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2147
OK
Other
Enumeration date
11/05/2014
Last updated
11/05/2014
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