Healthcare Provider Details

I. General information

NPI: 1467171801
Provider Name (Legal Business Name): CHRISTOPHER FOLSOM PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2022
Last Update Date: 08/26/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHRISTOPHER FOLSOM 804 COUNTY STREET 2940
TUTTLE OK
73089-2417
US

IV. Provider business mailing address

PO BOX 423
TUTTLE OK
73089-0423
US

V. Phone/Fax

Practice location:
  • Phone: 405-250-0721
  • Fax:
Mailing address:
  • Phone: 405-250-0721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3368
License Number StateOK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: