Individual
NICOLE MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
920 E 16TH ST, CLAREMORE, OK 74017-3165
(918) 283-1257
Mailing address
920 E 16TH ST, CLAREMORE, OK 74017-3165
(918) 283-1257
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1938
OK
Other
Enumeration date
04/12/2013
Last updated
04/12/2013
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