Individual
MR. RALPH FREDERICK JEROME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
112 EVANS AVENUE, MANNFORD, OK 74044
(918) 865-7020
(918) 865-7039
Mailing address
PO BOX 361, MANNFORD, OK 74044-0361
(918) 865-7020
(918) 865-7039
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2974
OK
Other
Enumeration date
03/19/2007
Last updated
10/15/2021
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