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Individual

AMANDA LANGWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2020 ARLINGTON ST STE 1, ADA, OK 74820-2822
(580) 332-5124
Mailing address
1214 E CORONA ST, ADA, OK 74820-2631
(580) 399-5015

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1433
LICENSE #
OK
Enumeration date
08/30/2006
Last updated
07/08/2007
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