Healthcare Provider Details

I. General information

NPI: 1538576715
Provider Name (Legal Business Name): DEVIN TRACHMAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEVIN VASSELLA PT

II. Dates (important events)

Enumeration Date: 07/19/2014
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15101 LLEYTONS CT STE 102
EDMOND OK
73013-2248
US

IV. Provider business mailing address

440 MERCHANT DR
NORMAN OK
73069-6470
US

V. Phone/Fax

Practice location:
  • Phone: 405-726-1580
  • Fax:
Mailing address:
  • Phone: 405-809-8710
  • Fax: 405-573-6768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4807
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: