Individual
BENJAMIN WAIN WORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
7666 E 61ST ST STE 340, TULSA, OK 74133-1148
(918) 250-3636
Mailing address
14547 N LANTANA BLVD, SKIATOOK, OK 74070-3894
(417) 459-0406
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4300
OK
Other
Enumeration date
07/09/2008
Last updated
12/13/2012
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