Individual
MRS. LINDA SUE CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3401 W GORE BLVD, LAWTON, OK 73505-6332
(580) 355-8620
Mailing address
104 COPPER MOUNTAIN DR, LAWTON, OK 73507-9016
(580) 529-2198
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
TA 187
OK
Other
Enumeration date
06/25/2007
Last updated
07/08/2007
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