Individual
MRS. STEPHANIE FAITH ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4612 S HARVARD AVE, SUITE B, TULSA, OK 74135-2908
(918) 744-1331
(918) 744-1596
Mailing address
3009 W ELGIN PL, BROKEN ARROW, OK 74012-2256
(918) 459-0565
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
OKTA278
OK
Other
Enumeration date
07/24/2006
Last updated
02/23/2009
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