Search › Oklahoma › 224Z00000X
Raymond Wallace, COTA/L
NPI 1003490228 · on the registry since 2021 · sole proprietor
Practice
- Address
- 6956 S 310th East Ave
Broken Arrow, OK 74014 - Phone
- (918) 230-8099
Registry record
- Primary taxonomy
- 224Z00000X
224Z00000X
- Licence states on file
- OK
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-05-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma