Britny Wallen, PTA

Individual provider Active NPI Physical Therapy Assistant · Mounds, OK

NPI 1124229711 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1124229711
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
1423 (OK)
Practice address
1825 N 189 Rd
Mounds, OK 74047-6221
Phone
(918) 756-9211
NPI assigned
May 30, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1423OKMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1423 OK Yes

Addresses

Primary practice location

1825 N 189 Rd
Mounds, OK 74047-6221

Mailing address

1825 N 189 Rd
Mounds, OK 74047-6221
Phone (918) 756-9211

Other providers in Mounds, OK

All providers in Mounds, OK · Physical Therapy Assistant in Oklahoma

Sources for this page

Verify at the official NPI Registry.