Healthcare Provider Details

I. General information

NPI: 1336886977
Provider Name (Legal Business Name): JOHN DANIEL LAIR PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2022
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 12TH AVE SE STE 306
NORMAN OK
73071-2567
US

IV. Provider business mailing address

10325 GREENBRIAR PL STE B
OKLAHOMA CITY OK
73159-7647
US

V. Phone/Fax

Practice location:
  • Phone: 405-759-7719
  • Fax: 405-759-7718
Mailing address:
  • Phone: 405-759-7719
  • Fax: 405-759-7718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: