Individual
DAN CHARBONEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
511 N MONTE VISTA ST, ADA, OK 74820-4611
(580) 436-3633
(580) 436-2977
Mailing address
511 N MONTE VISTA ST, ADA, OK 74820-4611
(580) 436-3633
(580) 436-2977
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2218
OK
Other
Enumeration date
06/14/2006
Last updated
05/28/2008
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