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NPI Code Detail

MEDICARE: KATELYN KNIGHT PTA

MEDICARE: KATELYN KNIGHT PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant3674OK

General Provider Information

NPI Number : 1396428959
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN KNIGHT PTA
Provider Business Mailing Address
First Line : 7541 S MINGO RD APT 9117
Second Line :
City : TULSA
State : OK
Zip : 74133-3391
Country : US
Telephone Number : 580-716-8941
Fax Number :
Provider Business Practice Location Address
First Line : 14002 E 21ST ST STE 650
Second Line :
City : TULSA
State : OK
Zip : 74134-1432
Country : US
Telephone Number : 918-274-7902
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2023
Last Update Date : 08/10/2023

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Directions to “ KATELYN KNIGHT PTA” Practice Location

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