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Individual

MS. BRIDGETTE ANNETTE ROACH

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
101 S MOORE AVE, CLAREMORE, OK 74017-5047
(918) 342-6214
Mailing address
11736 E 520 RD, CLAREMORE, OK 74019-5641
(918) 343-9695

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2260
OK

Other

Enumeration date
11/21/2005
Last updated
07/08/2007
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