Individual
JILL BUSSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
6800 NW 39TH EXPY, BETHANY, OK 73008-2513
(405) 440-2242
(405) 782-0024
Mailing address
6800 NW 39TH EXPY, BETHANY, OK 73008-2513
(405) 440-2242
(405) 782-0024
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
4941
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200599570A
—
OK
Enumeration date
08/10/2015
Last updated
10/19/2015
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