Individual
JACOB TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
6101 W RENO AVE STE 800, OKLAHOMA CITY, OK 73127-6592
(405) 495-3085
Mailing address
3908 LAKESHIRE RIDGE CT, EDMOND, OK 73034-1049
(918) 931-7052
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5543
OK
Other
Enumeration date
06/20/2018
Last updated
06/20/2018
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