Healthcare Provider Details

I. General information

NPI: 1346156114
Provider Name (Legal Business Name): SARAH MICHELLE JURKIEWICZ PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 W 151ST ST S
GLENPOOL OK
74033-4523
US

IV. Provider business mailing address

140 W 151ST ST S
GLENPOOL OK
74033-4523
US

V. Phone/Fax

Practice location:
  • Phone: 918-321-7480
  • Fax: 918-321-7488
Mailing address:
  • Phone: 918-321-7480
  • Fax: 918-321-7488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number4316
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: