TY ALAN JACKSON

DURANT, OK
NPI1679236871
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: OK  3010)
Enumeration Date2021-10-15
Last Update Date2021-10-15
Business Address
TY ALAN JACKSON PTA
1801 CHUKKA HINA
DURANT, OK 74701-7117
Phone number: 580-920-2100
Mailing Address
TY ALAN JACKSON PTA
5450 ROADRUNNER DR
DURANT, OK 74701-2451
Phone number: 580-775-3227