Healthcare Provider Details

I. General information

NPI: 1942885991
Provider Name (Legal Business Name): RACHEL FEARING PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2021
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 MERCHANT DR
NORMAN OK
73069-6470
US

IV. Provider business mailing address

440 MERCHANT DR
NORMAN OK
73069-6470
US

V. Phone/Fax

Practice location:
  • Phone: 405-579-1600
  • Fax:
Mailing address:
  • Phone: 450-809-8713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number3144
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: