Individual
MICHAEL VICTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2225 N MAIN ST, MIAMI, OK 74354-1620
(918) 542-4101
Mailing address
PO BOX 1, AFTON, OK 74331-0001
(918) 257-0082
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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