Individual
STEVI LYNN CASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
923 D ST NW, MIAMI, OK 74354-3232
(918) 314-6628
Mailing address
923 D ST NW, MIAMI, OK 74354-3232
(918) 314-6628
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-02608
KS
225200000X
Physical Therapy Assistant
2307
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14-02608
PTA LICENSURE
KS
01
—
2307
PTA LICENSURE
OK
Enumeration date
09/26/2013
Last updated
09/26/2013
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