Individual
JARAH EAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
13500 BRANDON PL, OKLAHOMA CITY, OK 73142-4312
(405) 720-0010
Mailing address
13500 BRANDON PL, OKLAHOMA CITY, OK 73142-4312
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3710
OK
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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