Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 1659 | OK |
NPI | 1013296318 |
---|---|
Provider Name | Tung Le |
First Address | Oklahoma City, OK 73112-5627 |
Second Address | Oklahoma City, OK 73112-5627 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2011 |
Last Update Date | 04/08/2011 |