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Individual

CODY ROBERT PAYNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
3613 NW 56TH ST, SUITE 202, OKLAHOMA CITY, OK 73112-4526
(405) 948-8686
(405) 978-8603
Mailing address
3613 NW 56TH ST, SUITE 202, OKLAHOMA CITY, OK 73112-4526
(405) 948-8686
(405) 978-8603

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1197631
TX
225100000X
Physical Therapist
Primary
4021
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200132560A
OK
01
4021
STATE LICENSE
OK
Enumeration date
07/31/2007
Last updated
10/27/2014
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