Healthcare Provider Details

I. General information

NPI: 1356940720
Provider Name (Legal Business Name): OYKU ESKICI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2020
Last Update Date: 10/18/2020
Certification Date: 10/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 W 143RD ST APT 210
BURNSVILLE MN
55306-4992
US

IV. Provider business mailing address

1421 W 143RD ST APT 210
BURNSVILLE MN
55306-4992
US

V. Phone/Fax

Practice location:
  • Phone: 515-779-7999
  • Fax:
Mailing address:
  • Phone: 515-779-7999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA2548
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: