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1326734013
TIFFANY RAE PANNELL
TULSA, OK
NPI
1326734013
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: OK 1674)
Enumeration Date
2023-04-14
Last Update Date
2023-04-14
Business Address
TIFFANY RAE PANNELL PTA
6705 E 81ST ST STE. 170
TULSA, OK 74133-4171
Phone number: 918-710-5790
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Mailing Address
TIFFANY RAE PANNELL PTA
204 W. WALNUT ST
COWETA, OK 74429
Phone number: 918-520-7661
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