Individual
KATHRYN LEAH MUZLJAKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
536 N MAIN ST, MUSKOGEE, OK 74401-6345
(918) 683-8555
(918) 683-8552
Mailing address
2234 W HOUSTON ST STE B, BROKEN ARROW, OK 74012-3519
(918) 259-1888
(918) 251-3725
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
5908
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200951460A
—
OK
01
—
5908
STATE LICENSE
OK
Enumeration date
11/03/2020
Last updated
03/12/2021
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