Healthcare Provider Details

I. General information

NPI: 1104746577
Provider Name (Legal Business Name): BARBARA REANE MATHIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BARBARA REANEA BOYER LMT

II. Dates (important events)

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

III. Provider practice location address

24778 190TH ST
PURCELL OK
73080-6741
US

IV. Provider business mailing address

24778 190TH ST
PURCELL OK
73080-6741
US

V. Phone/Fax

Practice location:
  • Phone: 405-274-9986
  • Fax:
Mailing address:
  • Phone: 405-274-9986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number176089
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: