Individual
ANDRA LEA BRANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1505 E STEVE OWENS BLVD, MIAMI, OK 74354-7917
(918) 542-4101
Mailing address
1089 S JEFFERSON ST, WELCH, OK 74369-9309
(918) 788-3142
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
938
OK
Other
Enumeration date
04/06/2009
Last updated
04/06/2009
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