Healthcare Provider Details
I. General information
NPI: 1740660018
Provider Name (Legal Business Name): MEGAN C BANKS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/02/2015
Last Update Date: 02/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
923 N ROBINSON AVE
OKLAHOMA CITY OK
73102-5845
US
IV. Provider business mailing address
440 MERCHANT DR
NORMAN OK
73069-6470
US
V. Phone/Fax
- Phone: 405-231-4200
- Fax: 405-231-5800
- Phone: 405-809-8710
- Fax: 405-573-6768
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 11-05073 |
| License Number State | KS |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 5269 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: