RUSSELL D BERRY

MANGUM, OK
NPI1972716512
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: OK  812)
Enumeration Date2007-05-08
Last Update Date2010-03-29
Business Address
-- RUSSELL D BERRY LPTA
1 WICKERSHAM ST
MANGUM, OK 73554-9117
Phone number: 580-782-3353
Mailing Address
-- RUSSELL D BERRY LPTA
PO BOX 104
GRANITE, OK 73547-0104
Phone number: 580-535-4581