Individual
CHERYL GENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1107 W BROADWAY ST, ARDMORE, OK 73401-2833
(580) 226-5566
Mailing address
1405 4TH AVE NW # 296, ARDMORE, OK 73401-2708
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2090
OK
Other
Enumeration date
04/10/2017
Last updated
04/10/2017
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