Jennifer Cabaniss
Individual provider Active NPI Physical Therapy Assistant · Mooreland, OK
NPI 1679964803 · NPPES record last updated Feb 10, 2015
Key facts
- NPI
- 1679964803
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2000 (OK)
- Practice address
- 402 SE 6TH St
Mooreland, OK 73852-9064 - Phone
- (888) 873-4221
- NPI assigned
- Feb 10, 2015
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2000 | OK | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2000 | OK | Yes |
Addresses
Primary practice location
402 SE 6TH St
Mooreland, OK 73852-9064
Mailing address
402 SE 6TH St
Mooreland, OK 73852-9064
Phone (888) 873-4221
Other providers in Mooreland, OK
- Jessica Marie Anderson
- Julia Lynn Brockway I
- Wendy Denae Crotts
- Julie Beth Daily
- Lacey Ann Duffy
- Elite Healthcare Clinic LLC
- Linda Kay Hardin
All providers in Mooreland, OK · Physical Therapy Assistant in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.