Individual
MISS JAIMIE RUTH TOLLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
122 W. 4TH ST., BRISTOW, OK 74010
(918) 358-2501
Mailing address
1878 OLD TOWNE RD, SAND SPRINGS, OK 74063-7272
(918) 706-9086
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT148
OK
Other
Enumeration date
06/29/2007
Last updated
07/29/2009
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