Individual
MS. ANDREA MARCY EMMETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
9309 E RENO AVE, MIDWEST CITY, OK 73130-3321
(405) 732-3353
Mailing address
1101 LARCHMONT LN, NICHOLS HILLS, OK 73116-6101
(308) 293-3916
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3982
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200134940A
—
OK
01
—
320092579
TRICARE
OK
Enumeration date
03/10/2008
Last updated
03/11/2010
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