Healthcare Provider Details

I. General information

NPI: 1962510586
Provider Name (Legal Business Name): CHARLOTTE ERMELING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHARLOTTE COTTRELL

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 E VETERANS MEMORIAL HWY
BLANCHARD OK
73010-9215
US

IV. Provider business mailing address

4812 E 33RD ST
TULSA OK
74135-2038
US

V. Phone/Fax

Practice location:
  • Phone: 405-809-8705
  • Fax:
Mailing address:
  • Phone: 918-622-4126
  • Fax: 918-270-2398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: