Individual
MS. WESUI CHAUNTE' GILMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6312 N PORTLAND AVE, OKLAHOMA CITY, OK 73112-1463
(405) 946-6932
Mailing address
6312 N PORTLAND AVE, OKLAHOMA CITY, OK 73112-1463
(405) 946-6932
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2049
OK
Other
Enumeration date
11/03/2021
Last updated
11/03/2021
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