Individual
CARLY RAE SCALLORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
20926 SE 29TH ST STE C, HARRAH, OK 73045-6610
(405) 391-2300
Mailing address
PO BOX 3675, SHAWNEE, OK 74802-3675
(405) 214-0300
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3337
OK
Other
Enumeration date
03/08/2021
Last updated
03/08/2021
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