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General NPI Number Information
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NPI Number | 1366706889
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Entity Type | Individual
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Provider Name | ELIZABETH EDISON FIELDING PT
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Gender | Female
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Dates
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Enumeration Date | 06/29/2012
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Last Update Date | 06/29/2012
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Provider Practice Location Address
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Address Line | 910 W CADDO ST
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City | CLEVELAND
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State | OK
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Zip | 74020-4202
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Country | US
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Telephone | 918-760-0321
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Fax | 918-358-5230
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Provider Business Mailing Address
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Address Line | 1505 ROCK RIDGE DR
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City | CLEVELAND
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State | OK
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Zip | 74020-9676
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Country | US
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Telephone | 918-760-0321
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Fax | 918-358-5230
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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 | PT985
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License Number State | OK
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