Individual
TIFFANY THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19600 E ROSS ST, TAHLEQUAH, OK 74464-0545
(539) 234-1000
Mailing address
15759 N BRYANT RD, TAHLEQUAH, OK 74464-1101
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3213
OK
Other
Enumeration date
02/17/2021
Last updated
02/17/2021
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