Quincy Anderson

Individual provider Active NPI Physical Therapist · Midwest City, OK

NPI 1184054355 · NPPES record last updated Nov 25, 2013

Key facts

NPI
1184054355
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
4498 (OK)
Practice address
6904 E Reno Ave
Midwest City, OK 73110-2152
Phone
(405) 737-5555
NPI assigned
Nov 25, 2013
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4498 OK Yes

Addresses

Primary practice location

6904 E Reno Ave
Midwest City, OK 73110-2152

Mailing address

6904 E Reno Ave
Midwest City, OK 73110-2152
Phone (405) 737-5555

Other providers in Midwest City, OK

All providers in Midwest City, OK · Physical Therapist in Oklahoma

Sources for this page

Verify at the official NPI Registry.