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NPI Code Detail

MEDICARE: CONNIE CREAGER

MEDICARE: CONNIE CREAGER
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 Therapist

General Provider Information

NPI Number : 1477767507
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONNIE CREAGER
Provider Business Mailing Address
First Line : 10710 E 74TH PL
Second Line :
City : TULSA
State : OK
Zip : 74133-2502
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6525 N MERIDIAN AVE STE 311
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73116-1410
Country : US
Telephone Number : 405-721-1115
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2007
Last Update Date : 07/08/2007

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Directions to “ CONNIE CREAGER ” Practice Location

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