Individual
ROGER MAGTANGOB BONAOBRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
3001 W BLUE STARR DR, CLAREMORE, OK 74017-2544
(918) 342-1651
Mailing address
1308 S KALANCHOE AVE, BROKEN ARROW, OK 74012-0988
(918) 286-6779
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT2192
OK
Other
Enumeration date
12/04/2013
Last updated
12/04/2013
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