Individual
KEITH JAMES FUKSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
723 W RANDOLPH AVE, SUITE 1, ENID, OK 73701-3826
(580) 234-1115
(580) 234-1150
Mailing address
723 W RANDOLPH AVE, SUITE 1, ENID, OK 73701-3826
(580) 234-1115
(580) 234-1150
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3116
OK
Other
Enumeration date
04/22/2009
Last updated
04/22/2009
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