MEDICARE: DARDEN SCHELL APPLE 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
1	225200000X	Physical Therapy Assistant	3297	OK

General Provider Information

NPI Number	:	1629660600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARDEN SCHELL APPLE PTA

Provider Business Mailing Address
First Line	:	PO BOX 746
Second Line	:
City	:	HARRAH
State	:	OK
Zip	:	73045-0746
Country	:	US
Telephone Number	:	405-454-0010
Fax Number	:

Provider Business Practice Location Address
First Line	:	5002 S ANDERSON RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73150-3800
Country	:	US
Telephone Number	:	405-732-0500
Fax Number	:	405-732-0550

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

Provider Enumeration Date	:	02/10/2021
Last Update Date	:	02/10/2021

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Directions to “ DARDEN SCHELL APPLE PTA” Practice Location

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