Individual
JASON EDWARD GATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, MHA, NCS
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 456-3905
Mailing address
1703 AUTUMN LN, SHAWNEE, OK 74804-4238
(405) 290-8589
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3083
OK
Other
Enumeration date
01/09/2008
Last updated
05/16/2023
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