Individual
MRS. TAMMY LYNN FETZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
102 E GORE BLVD, LAWTON, OK 73501-3025
(580) 353-0334
Mailing address
102 E GORE BLVD, LAWTON, OK 73501-3025
(580) 353-0334
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1706
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73-6029956
—
OK
Enumeration date
09/13/2007
Last updated
09/30/2015
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