Healthcare Provider Details
I. General information
NPI: 1912587452
Provider Name (Legal Business Name): QUEST NORMAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/09/2021
Last Update Date: 04/09/2021
Certification Date: 04/09/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1012 24TH AVE NW STE 130
NORMAN OK
73069-6485
US
IV. Provider business mailing address
1012 24TH AVE NW STE 130
NORMAN OK
73069-6485
US
V. Phone/Fax
- Phone: 405-601-4303
- Fax: 405-703-9144
- Phone: 405-601-4303
- Fax: 405-703-9144
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225XP0019X |
| Taxonomy | Physical Rehabilitation Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELIZABETH
HYLTON
Title or Position: CO-OWNER
Credential: OT
Phone: 405-601-4303