Individual
MR. TONY THOTTUKADAVIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.O.
Contact information
Practice address
4207 W MEMORIAL RD, OKLAHOMA CITY, OK 73134
(405) 525-4000
Mailing address
8236 NW 160TH TER, EDMOND, OK 73013-3350
(718) 285-5398
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
—
222Z00000X
Orthotist
Primary
C52463
OK
Other
Enumeration date
03/30/2017
Last updated
04/12/2019
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