Organization
THERAPYTIME PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANETTE RAE DECELLE PT (PRESIDENT)
(918) 712-1868
Entity
Organization
Contact information
Practice address
4157 S HARVARD AVE STE 101, TULSA, OK 74135-2606
(918) 712-7868
(918) 749-2901
Mailing address
4157 S HARVARD AVE STE 101, TULSA, OK 74135-2606
(918) 712-7868
(918) 749-2901
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1780
OK
225100000X
Physical Therapist
PT2077
OK
Other
Enumeration date
04/07/2007
Last updated
09/10/2007
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