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NPI Code Detail

MEDICARE: DANIELLA SARA PETERS PT

MEDICARE: DANIELLA SARA PETERS 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 Therapist5140OK

General Provider Information

NPI Number : 1932653201
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLA SARA PETERS PT
Provider Business Mailing Address
First Line : 440 MERCHANT DR
Second Line :
City : NORMAN
State : OK
Zip : 73069-6470
Country : US
Telephone Number : 405-809-8710
Fax Number : 405-573-6768
Provider Business Practice Location Address
First Line : 6600 N OLIE AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73116-7331
Country : US
Telephone Number : 405-227-9445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2016
Last Update Date : 12/06/2019

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Directions to “ DANIELLA SARA PETERS PT” Practice Location

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