Organization
STRUCTURAL REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACY L. STANDRIDGE D.C. (OWNER)
(918) 272-7491
Entity
Organization
Contact information
Practice address
12707 EAST 86TH STREET NORTH, OWASSO, OK 74055
(918) 272-7491
(918) 272-7491
Mailing address
12707 EAST 86TH STREET NORTH, OWASSO, OK 74055
(918) 272-7491
(918) 272-7448
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
11/21/2006
Last updated
08/22/2020
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