Individual
EUDORA R. OWOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
NONE CURRENTLY, MARION, AR 72364-1296
(770) 289-2881
Mailing address
PO BOX 1296, MARION, AR 72364-1296
(770) 289-2881
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1730
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT1730
LICENSCE NUMBER
OK
Enumeration date
04/03/2007
Last updated
07/08/2007
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