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Individual

MS. STACY MARIE BIDDLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
10229 E 96TH ST N, SUITE 102, OWASSO, OK 74055-5305
(918) 274-8541
(918) 274-8560
Mailing address
10229 E 96TH ST N, SUITE 102, OWASSO, OK 74055-5305
(918) 274-8541
(918) 274-8560

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4535
OK
225100000X
Physical Therapist
7501
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
179814
AZ
Enumeration date
01/17/2007
Last updated
06/03/2015
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