Individual
MISTY MCMULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
13720 E 86TH ST N, OWASSO, OK 74055-8704
(918) 609-8088
(918) 609-8089
Mailing address
6585 S YALE AVE STE 200, TULSA, OK 74136-8315
(918) 481-2767
(918) 494-9277
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1453
OK
Other
Enumeration date
03/20/2017
Last updated
06/05/2020
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