Clayton Kincannon, PTA

NPI #1982372553 in Woodward, Oklahoma

Provider Information

NPI Number: 1982372553
Entity Type: Individual
Name: Clayton Kincannon, PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Aug 31, 2021
Last Updated: Aug 31, 2021

Practice Location

Address: 2630 OKLAHOMA AVE
City: Woodward
State: Oklahoma
ZIP Code: 73801-4010
Phone: (580) 256-2102

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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