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1184837064
KENNETH WAYNE WATERS
BROKEN ARROW, OK
NPI
1184837064
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: OK PT 1396)
Enumeration Date
2007-05-08
Last Update Date
2007-07-08
Business Address
Mr. KENNETH WAYNE WATERS PT, MBA
2704 S ASPEN CT
BROKEN ARROW, OK 74012-7301
Phone number: 918-451-5143
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Mailing Address
Mr. KENNETH WAYNE WATERS PT, MBA
2704 S ASPEN CT
BROKEN ARROW, OK 74012-7301
Phone number: 918-645-1803
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