Healthcare Provider Details

I. General information

NPI: 1063968626
Provider Name (Legal Business Name): LYNDSAY ROPER MOTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 09/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3730 LEGACY DR. SUITE 3730
WEATHERFORD OK
73096-5443
US

IV. Provider business mailing address

1320 HICKORY ST
WEATHERFORD OK
73096-2743
US

V. Phone/Fax

Practice location:
  • Phone: 580-772-2604
  • Fax: 580-772-2906
Mailing address:
  • Phone: 760-402-4259
  • Fax: 580-772-2906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number1694
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number1694
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number1694
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: