MEDICARE: JONATHAN EDWARD GRESS 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
1	225100000X	Physical Therapist	6791	OK
2	2255A2300X	Athletic Trainer	1423	OK

General Provider Information

NPI Number	:	1851683221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN EDWARD GRESS PT

Provider Business Mailing Address
First Line	:	180 W BROOKS ST
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73019-1018
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 W BROOKS ST
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73019-1018
Country	:	US
Telephone Number	:	405-325-8331
Fax Number	:

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

Provider Enumeration Date	:	05/04/2011
Last Update Date	:	01/21/2026

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Directions to “ JONATHAN EDWARD GRESS PT” Practice Location

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