Organization
SHAWNEE PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA S TANNER (PT/OWNER)
(405) 878-8686
Entity
Organization
Contact information
Practice address
909 N KICKAPOO AVE, SHAWNEE, OK 74801-5729
(405) 878-8686
Mailing address
909 N KICKAPOO AVE, SHAWNEE, OK 74801-5729
(405) 878-8686
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT1924
OK
Other
Enumeration date
09/10/2007
Last updated
04/24/2012
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