Individual
TIFFANY MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
304 S 29TH ST, CHICKASHA, OK 73018-2501
(405) 224-3100
Mailing address
440 MERCHANT DR, NORMAN, OK 73069-6470
(405) 809-8713
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1495
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1495
PTA LICENSE
OK
Enumeration date
03/12/2021
Last updated
03/12/2021
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