Individual
MRS. BEVERLY K. FENTRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
6112 WINCHESTER DR, OKLAHOMA CITY, OK 73162-1719
(405) 621-9378
Mailing address
6112 WINCHESTER DR, OKLAHOMA CITY, OK 73162-1719
(405) 621-9378
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
687
OK
Other
Enumeration date
10/21/2011
Last updated
10/21/2011
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