Healthcare Provider Details

I. General information

NPI: 1013848258
Provider Name (Legal Business Name): MITCHELL CAMERON STROUD PT,DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10325 GREENBRIAR PL STE B
OKLAHOMA CITY OK
73159-7647
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:
Mailing address:
  • Phone: 405-759-7719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6716
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: