Healthcare Provider Details

I. General information

NPI: 1538070883
Provider Name (Legal Business Name): NEURO PERFORMANCE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 S BOSTON AVE STE 1130-17
TULSA OK
74103-3706
US

IV. Provider business mailing address

320 S BOSTON AVE STE 1130-17
TULSA OK
74103-3706
US

V. Phone/Fax

Practice location:
  • Phone: 918-221-7101
  • Fax:
Mailing address:
  • Phone: 918-221-7101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KYLIE JOLEN VOLK
Title or Position: OWNER
Credential: DPT
Phone: 918-859-4546