Healthcare Provider Details

I. General information

NPI: 1609396605
Provider Name (Legal Business Name): CASSIOPEIA J. KRIEGER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 09/01/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W. BOYD ST.
NORMAN OK
73069-4801
US

IV. Provider business mailing address

1201 W. BOYD ST.
NORMAN OK
73069-4801
US

V. Phone/Fax

Practice location:
  • Phone: 405-366-7898
  • Fax: 405-366-0010
Mailing address:
  • Phone: 405-366-7898
  • Fax: 405-366-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3795
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: