Individual
MR. CHARLES EDWARD RAY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
2021 MAHANEY AVE, SUITE 6, TAHLEQUAH, OK 74464-5794
(918) 458-5115
(918) 458-5119
Mailing address
2021 MAHANEY AVE, SUITE 6, TAHLEQUAH, OK 74464-5794
(918) 458-5115
(918) 458-5119
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2261
OK
Other
Enumeration date
08/26/2013
Last updated
08/26/2013
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