Individual
HAILEE LYNN WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
6585 S YALE AVE STE 445, TULSA, OK 74136-9703
(918) 481-2977
Mailing address
1016 E THOMPSON AVE, SAPULPA, OK 74066-4509
(918) 688-8409
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5493
OK
Other
Enumeration date
10/10/2022
Last updated
10/10/2022
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