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General NPI Number Information
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NPI Number | 1881550606
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Entity Type | Individual
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Provider Name | BLAKE CONNOR TUBBS
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Gender | Male
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Dates
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Enumeration Date | 12/26/2025
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 9309 E RENO AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73130-3321
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Country | US
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Telephone | 918-471-0202
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 BEDFORD DR
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City | NICHOLS HILLS
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State | OK
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Zip | 73116-6401
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Country | US
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Telephone | 918-471-0202
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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 | 6811
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License Number State | OK
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