Healthcare Provider Details

I. General information

NPI: 1669389789
Provider Name (Legal Business Name): PARKER BROOKS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 S ELM PL STE 230
BROKEN ARROW OK
74012-7825
US

IV. Provider business mailing address

2950 S ELM PL STE 230
BROKEN ARROW OK
74012-7825
US

V. Phone/Fax

Practice location:
  • Phone: 918-481-2979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6915
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: