Healthcare Provider Details

I. General information

NPI: 1689901852
Provider Name (Legal Business Name): TULSA PT CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2009
Last Update Date: 12/08/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6767 S YALE AVE # B
TULSA OK
74136-3302
US

IV. Provider business mailing address

6767 S YALE AVE STE B
TULSA OK
74136-3302
US

V. Phone/Fax

Practice location:
  • Phone: 918-494-3000
  • Fax: 918-494-0003
Mailing address:
  • Phone: 918-494-3000
  • Fax: 918-494-0003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MEGAN K TULLOCH
Title or Position: CFO
Credential:
Phone: 918-494-3000