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General NPI Number Information
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NPI Number | 1467653428
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Entity Type | Organization
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Legal Business Name | TULSA PUBLIC SCHOOLS
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 18321 S 131ST EAST AVE
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City | BIXBY
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State | OK
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Zip | 74008-7760
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Country | US
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Telephone | 918-366-8211
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Fax | 918-366-8213
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Provider Business Mailing Address
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Address Line | 18321 S 131ST EAST AVE
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City | BIXBY
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State | OK
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Zip | 74008-7760
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Country | US
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Telephone | 918-366-8211
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Fax | 918-366-8213
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Authorized Official
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Title or Position | PHYSICAL THERAPIST ASSISTANT
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Name | MRS. SHELLY ANN BROWN
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Credential | LICENS
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Telephone | 918-746-6114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 1388
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License Number State | OK
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