Individual
JACK FRIEND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3308 W OKMULGEE ST, MUSKOGEE, OK 74401-5069
(918) 683-7731
Mailing address
3308 W OKMULGEE ST, MUSKOGEE, OK 74401-5069
(918) 683-7731
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1826
OK
Other
Enumeration date
09/11/2009
Last updated
09/11/2009
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