Individual
MS. MY CHUONG TA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, PT, MPT
Contact information
Practice address
3328 N CLASSEN BLVD, OKLAHOMA CITY, OK 73118-3428
(405) 524-5200
(405) 524-5206
Mailing address
1516 SW 122ND ST, OKLAHOMA CITY, OK 73170-4855
(405) 620-6413
(405) 752-3191
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3619
OK
Other
Enumeration date
12/01/2011
Last updated
12/01/2011
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