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Individual

JONATHAN C ONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
13390 NE 23RD ST, CHOCTAW, OK 73020-8622
(405) 769-5555
(405) 769-5558
Mailing address
526 SW 4TH STREET, SUITE 200, MOORE, OK 73160
(918) 864-5848

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4481
OK
225100000X
Physical Therapist
PT38123
CA

Other

Enumeration date
09/08/2011
Last updated
08/04/2015
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