Individual
KAROLYN MASON PATTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2104 N BROADWAY ST, SUITEB, POTEAU, OK 74953-2501
(918) 640-0799
(918) 649-0797
Mailing address
1932 N BROADWAY ST, SUITE B, POTEAU, OK 74953-2501
(918) 649-0919
(918) 647-0979
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10178
NC
225100000X
Physical Therapist
2673
AR
225100000X
Physical Therapist
Primary
PT3521
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079UE
BCBS PROVIDER
NC
01
—
10178
NC STATE LICENSE
NC
05
—
200107250A
—
OK
01
—
460487007
TRICARE
OK
05
—
7211921
—
NC
01
—
P00405089
RR MEDICARE
OK
Enumeration date
10/24/2006
Last updated
05/28/2014
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