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1174278527
TAMMY SUE WAGONER
TULSA, OK
NPI
1174278527
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2251X0800X Physical Therapist, Orthopedic
(Licence: OK 2175)
Enumeration Date
2022-02-15
Last Update Date
2022-02-15
Business Address
TAMMY SUE WAGONER
4802 S 109TH EAST AVE
TULSA, OK 74146-5822
Phone number: 918-392-1513
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Mailing Address
TAMMY SUE WAGONER
4802 S 109TH EAST AVE
TULSA, OK 74146-5822
Phone number: 918-392-1513
Copy
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