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General NPI Number Information
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NPI Number | 1033740121
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Entity Type | Individual
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Provider Name | TAYLOR DEEANNE PITCOCK ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 01/28/2020
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Last Update Date | 01/28/2020
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Provider Practice Location Address
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Address Line | 180 W BROOKS ST NORMAN OK 1335-1
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City | NORMAN
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State | OK
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Zip | 73019-0001
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Country | US
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Telephone | 832-344-6352
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Fax | 405-325-8388
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Provider Business Mailing Address
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Address Line | 1300 STEAMBOAT WAY # 1335-1
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City | NORMAN
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State | OK
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Zip | 73071-7197
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Country | US
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Telephone | 832-344-6352
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1132
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License Number State | OK
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