Healthcare Provider Details

I. General information

NPI: 1497766489
Provider Name (Legal Business Name): RHONDA LEA MILLET M.S.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 E 15TH ST
TULSA OK
74120-5804
US

IV. Provider business mailing address

1310 E 15TH ST
TULSA OK
74120-5804
US

V. Phone/Fax

Practice location:
  • Phone: 918-599-0440
  • Fax:
Mailing address:
  • Phone: 918-599-0440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2960
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: