Individual
JACOB DYLAN BAKEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
101 N POST RD STE A, MIDWEST CITY, OK 73130-3605
(405) 397-3550
Mailing address
1345 HOMELAND AVE, NORMAN, OK 73072-5738
(405) 808-3752
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2556
OK
Other
Enumeration date
08/18/2023
Last updated
08/18/2023
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