Individual
JESS OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
924 STANLEY ST SW, ARDMORE, OK 73401-4636
(580) 465-8646
Mailing address
924 STANLEY ST SW, ARDMORE, OK 73401-4636
(580) 465-8646
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4539
OK
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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