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NPI Code Detail

MEDICARE: ALLIE CROW PT

MEDICARE: ALLIE CROW PT
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 Therapist5376OK

General Provider Information

NPI Number : 1801313879
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLIE CROW PT
Provider Business Mailing Address
First Line : 4812 E 33RD ST
Second Line :
City : TULSA
State : OK
Zip : 74135-2038
Country : US
Telephone Number : 918-622-4126
Fax Number : 918-270-2398
Provider Business Practice Location Address
First Line : 34637 AIRLINE RD
Second Line :
City : PAULS VALLEY
State : OK
Zip : 73075-8583
Country : US
Telephone Number : 405-238-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2017
Last Update Date : 08/29/2017

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Directions to “ ALLIE CROW PT” Practice Location

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