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NPI 1780571687

NPI 1780571687 : TALA THORNE-BATEMAN DPT : TULSA, OK

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General NPI Number Information
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    NPI Number           |    1780571687
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    Entity Type          |    Individual 
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    Provider Name        |    TALA THORNE-BATEMAN DPT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/23/2025
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    Last Update Date     |    06/23/2025
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Provider Practice Location Address
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    Address Line         |    4765 E 91ST ST STE 100 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74137-2843
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    Country              |    US
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    Telephone            |    539-444-4229
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    Fax                  |    539-444-4487
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Provider Business Mailing Address
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    Address Line         |    4613 E 25TH ST 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74114-4809
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    Country              |    US
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    Telephone            |    918-859-8763
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    6699
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    License Number State |    OK
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