MEDICARE: JEANETTE CARLIN PT, 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
1	225100000X	Physical Therapist	5299	OK

General Provider Information

NPI Number	:	1376054353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANETTE CARLIN PT, DPT

Provider Business Mailing Address
First Line	:	700 NW 7TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-1212
Country	:	US
Telephone Number	:	405-609-3658
Fax Number	:	800-506-3795

Provider Business Practice Location Address
First Line	:	7005 SE 15TH ST STE 200
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-5126
Country	:	US
Telephone Number	:	405-610-2488
Fax Number	:

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

Provider Enumeration Date	:	10/18/2017
Last Update Date	:	03/26/2024

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Directions to “ JEANETTE CARLIN PT, DPT” Practice Location

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