STACEY LONG

TULSA, OK
NPI1073977716
Former NameSTACEY LYNN KETCHUM
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: OK  2734)
Enumeration Date2016-04-08
Last Update Date2016-04-08
Business Address
-- STACEY LONG PT
4808 S 109TH EAST AVE SUITE 100
TULSA, OK 74146-5822
Phone number: 918-392-1482
Mailing Address
-- STACEY LONG PT
4808 S 109TH EAST AVE SUITE 100
TULSA, OK 74146-5822
Phone number: 918-392-1482
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