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General NPI Number Information
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NPI Number | 1144107574
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Entity Type | Individual
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Provider Name | SHANNON BEASLEY DPT
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Gender |
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 8802 E 71ST ST
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City | TULSA
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State | OK
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Zip | 74133-3186
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Country | US
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Telephone | 918-505-6940
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Fax |
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Provider Business Mailing Address
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Address Line | 1427 S DELAWARE PL
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City | TULSA
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State | OK
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Zip | 74104-4837
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 6506
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License Number State | OK
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