Healthcare Provider Details

I. General information

NPI: 1306849062
Provider Name (Legal Business Name): ELIZABETH B PARKHURST P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 07/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 BARNES AVE STE 2
ALVA OK
73717-2287
US

IV. Provider business mailing address

PO BOX 862
ALVA OK
73717-0862
US

V. Phone/Fax

Practice location:
  • Phone: 580-327-0732
  • Fax: 580-327-0737
Mailing address:
  • Phone: 580-327-0732
  • Fax: 580-327-0737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number546
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: