Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 1032 | OK |
NPI | 1033466305 |
---|---|
Provider Name | Ms. Judy Howard |
First Address | Edmond, OK 73003-2078 |
Second Address | Edmond, OK 73003-2078 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2012 |
Last Update Date | 06/08/2012 |