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Individual

DANIEL ADAM THIES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.O., C.O.

Contact information

Practice address
480 E 141ST ST STE E, GLENPOOL, OK 74033-3550
(918) 518-5980
(918) 518-5982
Mailing address
480 E 141ST ST STE E, GLENPOOL, OK 74033-3550
(918) 518-5980
(918) 518-5982

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
11
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200069410A
OK
Enumeration date
08/31/2006
Last updated
08/22/2019
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