Individual
MIRANDA JOANN WATFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 BUENA VISTA AVE, MIDWEST CITY, OK 73110-2604
(405) 251-9988
Mailing address
3700 12TH AVE SE APT 511, NORMAN, OK 73072-8323
(140) 556-7705
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3272
OK
Other
Enumeration date
08/27/2020
Last updated
08/27/2020
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