Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT 2229 | OK |
NPI | 1003073107 |
---|---|
Provider Name | Tressie Platt |
First Address | Norman, OK 73070-8250 |
Second Address | Glenpool, OK 74033-3524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2008 |
Last Update Date | 15/01/2020 |