Individual
CAMERON KEITH FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12910 E 86TH ST N, OWASSO, OK 74055-8701
(918) 274-1300
Mailing address
12700 E 100TH ST N APT 20204, OWASSO, OK 74055-9337
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2994
OK
Other
Enumeration date
10/16/2018
Last updated
10/16/2018
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