Individual
COURTNEY LEANN CAROTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2428 RIDGE RUN DR, BLANCHARD, OK 73010-9034
(405) 627-0929
Mailing address
2428 RIDGE RUN DR, BLANCHARD, OK 73010-9034
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1897
OK
Other
Enumeration date
07/09/2013
Last updated
07/09/2013
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