Individual
CHARLES JUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
24935 KY AVE, CLAREMORE, OK 74019-4348
(918) 231-9014
Mailing address
24935 KY AVE, CLAREMORE, OK 74019-4348
(918) 231-9014
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1476
OK
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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