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General NPI Number Information
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NPI Number | 1649024316
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Entity Type | Individual
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Provider Name | TAYLER M O'FIELD
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Gender | Female
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Dates
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Enumeration Date | 04/17/2024
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 1107 E 13TH ST
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City | GROVE
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State | OK
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Zip | 74344-7955
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Country | US
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Telephone | 918-786-8834
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Fax |
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Provider Business Mailing Address
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Address Line | 39499 S 640 RD
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City | JAY
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State | OK
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Zip | 74346-4625
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Country | US
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Telephone | 918-837-2796
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 198444-0
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License Number State | OK
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