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General NPI Number Information
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NPI Number | 1790490878
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Entity Type | Individual
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Provider Name | SHELBY LINFORD PTA
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Gender | Female
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Dates
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Enumeration Date | 01/23/2023
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 1776 E ROBINSON ST
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City | NORMAN
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State | OK
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Zip | 73071-7442
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Country | US
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Telephone | 405-561-0587
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Fax |
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Provider Business Mailing Address
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Address Line | 2355 SANDPIPER DR
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City | BLANCHARD
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State | OK
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Zip | 73010-8944
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Country | US
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Telephone | 405-509-0517
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2170
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License Number State | OK
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