Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 2065 | OK |
NPI | 1467840132 |
---|---|
Provider Name | Dawna G Riggenbach |
First Address | Jenks, OK 74037-4359 |
Second Address | Jenks, OK 74037-4359 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2015 |
Last Update Date | 05/01/2015 |