Kenneth Wayne Waters PT, MBA

NPI 1184837064 - Physical Therapist - 225100000X

NPI Details
NPI 1184837064
Gender Male
Enumeration Date 05/08/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
2704 S ASPEN CT
BROKEN ARROW OK, 74012-7301, US
Phone (918) 451-5143
Fax
Business Location
2704 S ASPEN CT
BROKEN ARROW OK, 74012-7301, US
Phone (918) 645-1803
Fax
Toxanomy
Taxonomy Code 225100000X
License State Oklahoma
License Number PT 1396
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According to our database, Mr. Kenneth Wayne Waters PT, MBA NPI is 1184837064, taxonomy code is 225100000X and license number is PT 1396, license state is located at Oklahoma. Kenneth Wayne Waters PT, MBA physically located at 2704 S Aspen Ct, Broken Arrow OK, 74012-7301. NPI Number Kenneth Wayne Waters PT, MBA has the Individual type.

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1184837064 NPI number is provided on an as is basis without warranty of any kind. 1184837064 is maintained by the National Plan & Provider Enumeration System. The contents of Kenneth Wayne Waters PT, MBA are for informational purposes only.