Individual
RYAN EDWARD ELASSAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
7919 MID AMERICA BLVD STE 100, OKLAHOMA CITY, OK 73135-6611
(405) 736-0064
Mailing address
16905 HALBROOKE CIR, EDMOND, OK 73012-6864
(405) 996-0660
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5329
OK
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1-E-8553
OK
Other
Enumeration date
01/16/2020
Last updated
09/24/2024
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