Individual
JODIE STUCKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 W HOUSTON ST, BROKEN ARROW, OK 74012-4519
(918) 250-8475
Mailing address
4300 W HOUSTON ST, BROKEN ARROW, OK 74012-4519
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TA586
OK
Other
Enumeration date
01/04/2013
Last updated
01/04/2013
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