Healthcare Provider Details

I. General information

NPI: 1164332672
Provider Name (Legal Business Name): WHITNEY LYNN OWENS PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N SIOUX AVE
CLAREMORE OK
74017-3128
US

IV. Provider business mailing address

1500 N SIOUX AVE
CLAREMORE OK
74017-3128
US

V. Phone/Fax

Practice location:
  • Phone: 918-923-4700
  • Fax: 918-923-4701
Mailing address:
  • Phone: 918-923-4700
  • Fax: 918-923-4701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number3392
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: