Individual
JESSA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10908C N MAY AVE, OKLAHOMA CITY, OK 73120-6202
(405) 297-4500
Mailing address
440 MERCHANT DR, NORMAN, OK 73069-6470
(405) 809-8713
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3532
OK
Other
Enumeration date
08/06/2022
Last updated
08/06/2022
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