Individual
MR. RUSSELL J. CASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2113 VANISHING TRL, EDMOND, OK 73013-2756
(405) 285-8477
(405) 285-8499
Mailing address
1410 FRETZ DR, EDMOND, OK 73003-5782
(405) 285-8477
(405) 285-8499
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4289
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299423
—
OR
Enumeration date
11/29/2005
Last updated
12/07/2011
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