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Individual

BOPHA TIEM GAMBILL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
4815 S HARVARD AVE STE 455, TULSA, OK 74135-3078
(918) 712-7805
Mailing address
20463 E 46TH ST S, BROKEN ARROW, OK 74014-8764
(918) 712-7805
(918) 712-7813

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3721
OK

Other

Enumeration date
05/21/2007
Last updated
07/08/2007
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