Individual
MISS CHERI ROSE BREASHEARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
7777 S LEWIS AVE, TULSA, OK 74171-0003
(918) 495-6806
Mailing address
7777 S LEWIS AVE, TULSA, OK 74171-0003
(918) 495-6806
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
578
OK
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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