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NPI Code Detail

MEDICARE: WILMA JEAN BRIGHT PTA

MEDICARE: WILMA JEAN BRIGHT PTA
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
1225200000XPhysical Therapy Assistant1557OK

General Provider Information

NPI Number : 1144811282
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILMA JEAN BRIGHT PTA
Provider Business Mailing Address
First Line : 101 OKLAHOMA AVE
Second Line :
City : MCALESTER
State : OK
Zip : 74501-7520
Country : US
Telephone Number : 918-421-3935
Fax Number : 918-421-3939
Provider Business Practice Location Address
First Line : 101 OKLAHOMA AVE
Second Line :
City : MCALESTER
State : OK
Zip : 74501-7520
Country : US
Telephone Number : 918-421-3935
Fax Number : 918-421-3939
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2021
Last Update Date : 02/01/2021

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