Individual
CASEY O'LEARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14140 BROADWAY EXT APT 436, EDMOND, OK 73013-4144
(804) 338-6452
Mailing address
14140 BROADWAY EXT APT 436, EDMOND, OK 73013-4144
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
OK
390200000X
Student in an Organized Health Care Education/Training Program
Primary
743
OK
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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