Individual
JACOB LEE TUTTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
302 NORTHRIDGE CIRCLE, GUYMON, OK 73942-5801
(580) 338-4789
(866) 999-0184
Mailing address
302 NORTHRIDGE CIRCLE, GUYMON, OK 73942-5801
(580) 338-4789
(866) 999-0184
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1104337
KS
225100000X
Physical Therapist
Primary
3766
OK
225100000X
Physical Therapist
8820
CO
Other
Enumeration date
04/06/2007
Last updated
08/08/2012
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