# PIECE OUT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003338302
- **Authorized official:** JAMIE SHACKELFORD MOT, OTR/L (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (405) 627-9325

## Contact information

- **Practice address:** 19454 PIONEER WAY, CASHION, OK 73016-5500
- **Practice address phone:** (405) 627-9325
- **Practice address fax:** (866) 486-4825
- **Mailing address:** 19454 PIONEER WAY, CASHION, OK 73016-5500
- **Mailing address phone:** (405) 627-9325
- **Mailing address fax:** (866) 486-4825

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | 1269 | OK | Yes |

## Other

- **Enumeration date:** 07/09/2017
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200267230B | — | OK |