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NPI Code Detail

MEDICARE: DR. CHARLOTTE ADELA BURNETT DPT

MEDICARE: DR. CHARLOTTE ADELA BURNETT DPT
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
1225100000XPhysical Therapist5642OK

General Provider Information

NPI Number : 1356984694
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLOTTE ADELA BURNETT DPT
Provider Business Mailing Address
First Line : 9136 S SHERIDAN RD STE B
Second Line :
City : TULSA
State : OK
Zip : 74133-5328
Country : US
Telephone Number : 918-488-9991
Fax Number : 918-488-9989
Provider Business Practice Location Address
First Line : 7401 RIVERSIDE PKWY UNIT 219
Second Line :
City : TULSA
State : OK
Zip : 74136-5057
Country : US
Telephone Number : 918-216-9303
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2019
Last Update Date : 03/10/2024

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Directions to “ DR. CHARLOTTE ADELA BURNETT DPT” Practice Location

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