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NPI Code Detail

MEDICARE: LORRA R HOUGHTON PTA

MEDICARE:   LORRA R HOUGHTON  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 AssistantPTA943OK

General Provider Information

NPI Number : 1447219787
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORRA R HOUGHTON PTA
Provider Business Mailing Address
First Line : 6767 S YALE AVE
Second Line : SUITE B
City : TULSA
State : OK
Zip : 74136-3302
Country : US
Telephone Number : 918-494-3000
Fax Number : 918-494-0003
Provider Business Practice Location Address
First Line : 6767 S YALE AVE
Second Line : SUITE B
City : TULSA
State : OK
Zip : 74136-3302
Country : US
Telephone Number : 918-494-3000
Fax Number : 918-494-0003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 06/14/2010

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Directions to “ LORRA R HOUGHTON PTA” Practice Location

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