Individual
RAVEN HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3030 NW EXPWY STE 809, OKLAHOMA CITY, OK 73112-5466
(866) 848-8813
Mailing address
3030 NW EXPWY STE 809, OKLAHOMA CITY, OK 73112-5466
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2746
OK
Other
Enumeration date
02/05/2019
Last updated
02/05/2019
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