Individual
JORDAN CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
527 GOTT RD, ENID, OK 73705-5105
(972) 921-8000
Mailing address
527 GOTT RD, ENID, OK 73705-5105
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1328690
TX
Other
Enumeration date
02/14/2020
Last updated
09/27/2023
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