Healthcare Provider Details

I. General information

NPI: 1134804180
Provider Name (Legal Business Name): TUYET RYKS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2023
Last Update Date: 06/19/2023
Certification Date: 06/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5021 SE 154TH CT
OKLAHOMA CITY OK
73165-7368
US

IV. Provider business mailing address

5021 SE 154TH CT
OKLAHOMA CITY OK
73165-7368
US

V. Phone/Fax

Practice location:
  • Phone: 405-820-2595
  • Fax:
Mailing address:
  • Phone: 405-820-2595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3566
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: