Individual
ASHLEY CHEYENNE SEVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3100
Mailing address
1400 HICKORY HILLS DR, FORT GIBSON, OK 74434-6387
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6591
OK
225200000X
Physical Therapy Assistant
2987
OK
Other
Enumeration date
01/28/2020
Last updated
08/07/2025
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