Individual
TERISA D. RASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4300 W HOUSTON ST, BROKEN ARROW, OK 74012-4519
(918) 798-8324
Mailing address
PO BOX 3492, BROKEN ARROW, OK 74013-3492
(918) 798-8324
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
66
OK
Other
Enumeration date
12/20/2012
Last updated
12/20/2012
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