Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 3532 | OK |
N | 2251N0400X | Physical Therapist - Neurology | 3532 | OK |
N | 2251X0800X | Physical Therapist - Orthopedic | 3532 | OK |
NPI | 1588633069 |
---|---|
Provider Name | Mrs. Julia Ann Ray |
First Address | Stillwater, OK 74074-3651 |
Second Address | Stillwater, OK 74074-3651 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 02/01/2008 |