Individual
MRS. CARENZA ANGELINE SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3030 NW EXPRESSWAY ST STE 809, OKLAHOMA CITY, OK 73112-5466
(405) 917-7160
Mailing address
2011 W 119TH ST S, JENKS, OK 74037-4380
(405) 613-5504
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1071
OK
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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