MEDICARE: MS. BRANDY MICHELLE DOOLIN P.T.

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	3801	OK

General Provider Information

NPI Number	:	1396881348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BRANDY MICHELLE DOOLIN P.T.

Provider Business Mailing Address
First Line	:	39909 DEMOY DR
Second Line	:
City	:	SHAWNEE
State	:	OK
Zip	:	74804-9674
Country	:	US
Telephone Number	:	405-831-5107
Fax Number	:	405-878-4792

Provider Business Practice Location Address
First Line	:	2904 PARKLAWN DRIVE
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-4232
Country	:	US
Telephone Number	:	405-732-8900
Fax Number	:	405-732-1771

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	02/02/2026

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