Individual
LEISHA RAE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3345 S HARVARD AVE STE 301, TULSA, OK 74135-1815
(918) 574-2575
Mailing address
3345 S HARVARD AVE STE 301, TULSA, OK 74135-1815
(318) 574-2575
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3444
OK
Other
Enumeration date
08/18/2021
Last updated
08/18/2021
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