Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 4836 | OK |
NPI | 1053877670 |
---|---|
Provider Name | Abby Jones |
First Address | Oklahoma City, OK 73134-1066 |
Second Address | Oklahoma City, OK 73134-1066 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2019 |
Last Update Date | 16/01/2022 |