| NPI | 1093838971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANETTE RAE DECELLE President 918-712-1868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK PT1780) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OK PT2077) |
| Enumeration Date | 2007-04-07 |
| Last Update Date | 2007-09-10 |