Individual
HAILEY GUADARRAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
29 N COMMERCE ST, ARDMORE, OK 73401
(580) 223-1925
Mailing address
PO BOX 1686, ARDMORE, OK 73402-1686
(580) 223-1925
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2581
OK
Other
Enumeration date
02/15/2016
Last updated
02/15/2016
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