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Individual

STORMY R DEATON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
62531 E 252 RD, GROVE, OK 74344-7462
(918) 961-8067
Mailing address
62531 E 252 RD, GROVE, OK 74344-7462
(918) 961-8067

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1642
OK

Other

Enumeration date
11/13/2008
Last updated
11/13/2008
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