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Individual

AMBER PRINCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
2334 SE WASHINGTON BLVD, BARTLESVILLE, OK 74006-7256
(918) 331-9184
(918) 331-9187
Mailing address
10100 FOREST HILLS RD, MACHESNEY PARK, IL 61115-8234
(815) 713-2738
(815) 713-2797

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1269
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200117320A
OK
Enumeration date
07/08/2009
Last updated
07/08/2009
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