Individual
GAYLA T POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2400 SE 34TH ST, MOORE, OK 73160-9718
(405) 799-4710
Mailing address
2400 SE 34TH ST, MOORE, OK 73160-9718
(405) 799-4710
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT18
OK
Other
Enumeration date
09/12/2010
Last updated
09/12/2010
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