Healthcare Provider Details

I. General information

NPI: 1699692137
Provider Name (Legal Business Name): ELIJAH O POWIS DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7690 E 126TH ST S STE 101
BIXBY OK
74008-2680
US

IV. Provider business mailing address

2488 E 81ST ST STE 290
TULSA OK
74137-4299
US

V. Phone/Fax

Practice location:
  • Phone: 918-394-2770
  • Fax: 918-927-3201
Mailing address:
  • Phone: 918-927-3199
  • Fax: 918-927-3193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7149
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: