Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 5801 | OK |
NPI | 1043842016 |
---|---|
Provider Name | Zac Howe |
First Address | Oklahoma City, OK 73106-4014 |
Second Address | Pauls Valley, OK 73075-8583 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2020 |
Last Update Date | 07/02/2020 |