Individual
KRYSTAL HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1601 ACADEMY RD, PONCA CITY, OK 74604-4409
(580) 762-0927
Mailing address
1601 ACADEMY RD, PONCA CITY, OK 74604-4409
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1558
OK
Other
Enumeration date
11/26/2012
Last updated
11/26/2012
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