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Organization

PIECE OUT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMIE SHACKELFORD MOT, OTR/L (OCCUPATIONAL THERAPIST)
(405) 627-9325
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1269
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200267230B
OK
Enumeration date
07/09/2017
Last updated
07/21/2022
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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