Healthcare Provider Details

I. General information

NPI: 1841299310
Provider Name (Legal Business Name): THERAPY TIME PT, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4157 S HARVARD AVE #117
TULSA OK
74135-2631
US

IV. Provider business mailing address

4157 S HARVARD AVE #117
TULSA OK
74135-2631
US

V. Phone/Fax

Practice location:
  • Phone: 918-712-7868
  • Fax: 917-749-2901
Mailing address:
  • Phone: 918-712-7868
  • Fax: 917-749-2901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIA B WILSON
Title or Position: PRESIDENT
Credential: PT
Phone: 918-712-7868