Individual
KEISHA FORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
1212 FOUR SEASONS DR, DURANT, OK 74701-2430
(580) 931-9218
(580) 924-1302
Mailing address
PO BOX 831, MADILL, OK 73446-0831
(580) 795-3301
(580) 795-7307
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3826
OK
Other
Enumeration date
08/30/2006
Last updated
07/09/2007
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