Healthcare Provider Details

I. General information

NPI: 1760581847
Provider Name (Legal Business Name): NANCY JANE GAWEY P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANE REYNOLDS GAWEY PT

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 07/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 W MEMORIAL RD
OKLAHOMA CITY OK
73120-8304
US

IV. Provider business mailing address

4300 W MEMORIAL RD
OKLAHOMA CITY OK
73120-8304
US

V. Phone/Fax

Practice location:
  • Phone: 405-341-7356
  • Fax: 405-341-3795
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number559
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: