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Individual

BAILEY SHOMO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
523 W MAIN ST, DURANT, OK 74701-5009
(580) 924-7700
Mailing address
812 N 11TH AVE, DURANT, OK 74701-3732
(580) 745-4440

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2555
OK

Other

Enumeration date
08/11/2015
Last updated
08/11/2015
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