Dan Charboneau, PHYSICAL THERAPIST

NPI #1770526667 in Ada, Oklahoma

Provider Information

NPI Number: 1770526667
Entity Type: Individual
Name: Dan Charboneau, PHYSICAL THERAPIST
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Credential: PHYSICAL THERAPIST
Enumeration Date: Jun 14, 2006
Last Updated: May 28, 2008

Practice Location

Address: 511 N MONTE VISTA ST
City: Ada
State: Oklahoma
ZIP Code: 74820-4611
Phone: (580) 436-3633

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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