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1548854557
JILLYAN AVERY LONG
TULSA, OK
NPI
1548854557
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: OK 3281)
Enumeration Date
2021-02-22
Last Update Date
2021-02-22
Business Address
JILLYAN AVERY LONG PTA
8165 S MINGO RD STE 101
TULSA, OK 74133-4667
Phone number: 918-615-6280
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Mailing Address
JILLYAN AVERY LONG PTA
8165 S MINGO RD STE 101
TULSA, OK 74133-4667
Phone number: 918-615-6280
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