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Individual

MR. TIMOTHY RYAN REASON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA/L

Contact information

Practice address
100 N LILLARD LN, SALLISAW, OK 74955-3009
(918) 315-7112
Mailing address
100 N LILLARD LN, SALLISAW, OK 74955-3009
(918) 315-7112

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213861
TX

Other

Enumeration date
06/28/2016
Last updated
06/28/2016
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