Most Relevant Information
Provider Data
| NPI Number: | 1003019167 |
| Provider Name: | MICHAEL RAYMOND CHILDRESS RPTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 770 |
Most Important Dates
| Enumeration Date: | 06/07/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
2408 E 81ST ST STE 300
TULSA
OK
741374200
Practice Location Phone/Fax
| Phone: | 9184775053 |
| Fax: | 9184775040 |
Provider Mailing Location
2408 E 81ST ST STE 300
TULSA
OK
741374200
Provider Mailing Phone/Fax
| Phone: | 9184775053 |
| Fax: | 9184775040 |