Healthcare Provider Details

I. General information

NPI: 1538432802
Provider Name (Legal Business Name): JAMIE LYNN MCCANN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMIE LYNN MCCANN DPT

II. Dates (important events)

Enumeration Date: 02/17/2012
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10512 N 110TH EAST AVE STE 150
OWASSO OK
74055-6651
US

IV. Provider business mailing address

10512 N 110TH EAST AVE STE 150
OWASSO OK
74055-6651
US

V. Phone/Fax

Practice location:
  • Phone: 918-376-8550
  • Fax: 918-550-6630
Mailing address:
  • Phone: 918-376-8550
  • Fax: 918-550-6630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4449
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: