MEDICARE: MS. BONNIELYN ELIZABETH FITE BARTON LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	182124	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023886827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BONNIELYN ELIZABETH FITE BARTON LMT

Provider Business Mailing Address
First Line	:	6209 S 116TH EAST AVE
Second Line	:
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012-1250
Country	:	US
Telephone Number	:	918-324-6201
Fax Number	:

Provider Business Practice Location Address
First Line	:	1615 S EUCALYPTUS AVE
Second Line	:
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012
Country	:	US
Telephone Number	:	918-324-6201
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2023
Last Update Date	:	12/03/2025

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