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General NPI Number Information
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NPI Number | 1497385546
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Entity Type | Individual
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Provider Name | HOLLY LOUISE TRUMBLE MOT/L
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Gender | Female
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Dates
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Enumeration Date | 01/16/2020
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Last Update Date | 01/16/2020
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Provider Practice Location Address
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Address Line | 117 W 5TH ST # 1
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City | BARTLESVILLE
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State | OK
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Zip | 74003-6651
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Country | US
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Telephone | 918-203-3313
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Fax | 918-512-4082
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Provider Business Mailing Address
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Address Line | 117 W 5TH ST STE 1
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City | BARTLESVILLE
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State | OK
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Zip | 74003-6651
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Country | US
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Telephone | 918-203-3313
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Fax | 918-512-4082
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5229
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License Number State | OK
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