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1205854288
TIM T MINNICK
BROKEN ARROW, OK
NPI
1205854288
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: OK 2542)
Enumeration Date
2006-07-17
Last Update Date
2015-04-30
Business Address
-- TIM T MINNICK MPT
2232 W HOUSTON ST
BROKEN ARROW, OK 74012-3529
Phone number: 918-259-9522
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Mailing Address
-- TIM T MINNICK MPT
2234 W HOUSTON ST STE B
BROKEN ARROW, OK 74012-3519
Phone number: 918-259-1888
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