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General NPI Number Information
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NPI Number | 1144883166
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Entity Type | Organization
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Legal Business Name | UNLIMITED POTENTIAL PEDIATRICS
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Dates
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Enumeration Date | 04/16/2019
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 3221 24TH AVE NW
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City | NORMAN
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State | OK
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Zip | 73069
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Country | US
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Telephone | 405-857-2007
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Fax | 405-353-6776
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Provider Business Mailing Address
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Address Line | 3221 24TH AVE NW
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City | NORMAN
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State | OK
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Zip | 73069
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Country | US
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Telephone | 405-857-2007
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Fax | 405-353-6776
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Authorized Official
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Title or Position | CO-OWNER AND THERAPIST
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Name | ELIZABETH MEDINA
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Credential | MOTR/L
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Telephone | 405-857-2007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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